非自杀性自伤（Non-Suicidal Self-Injury,NSSI，以下简称自伤）行为是一种区别于自杀行为的心理病理现象。自伤领域研究者最为关注的问题之一是：个体为什么会自伤?为解决这一问题，研究者已经寻找到多种自伤的影响因素，并从各种角度描述自伤发生的过程。这些研究及理论极大地丰富了人们对自伤行为的认识，却不能解释这样的现象：两个遭遇同样困难情境、有着同样危险因子的青少年，一个选择了攻击他人，一个却选择了自伤。此外，前人多关注较为远端的自伤影响因素，但对较近端的影响因素关注较少。基于此，本书将着重探讨从事件发生开始，是哪些因素导致个体产生了自伤行为而不是其他行为。具体来看，本书分为三个部分：

第一部分：自伤影响因素的质性研究。本书将探讨自伤的发生过程，着重关注直接影响自伤发生的因素。由于其中涉及的大量内部体验很难用量化的方法进行全面测量，本书将采用质性研究的方法，对这些影响因素进行深入分析。选取18名自伤者进行深度访谈，并采用共识性质性研究方法（CQR）对访谈材料进行分析。结果表明，从自伤的诱发事件产生到个体最终采取自伤行为，影响其最终选择自伤而非其他方式的因素可以划分为4个维度：触发事件、心理状态、自伤动机、方式选择。这几个维度组成一个有机整体，导致了自伤行为的发生。

第二部分：自伤关键影响因素的量化研究。质性研究结果显示，有4个因素与自伤关系密切：高情绪强度，对自伤的态度，自伤的“优势”，认知受限。因此，本书将在后续对这四个变量与自伤的关系分别进行量化检验。结果表明：高负性情绪会导致自伤者更倾向于选择自伤行为；自伤者对自伤行为持负性内隐态度，但与其他人群差异不显著；自伤能在更短的时间内让自伤者从负性情绪/认知中逃离；但从调节的效果来看，自伤和其他的调节方式并不存在显著差异；在高、低负性情绪下，自伤者与非自伤者的社会问题解决能力均无显著差异；不过在高负性情绪下，自伤者解决问题的自我效感能显著降低，而非自伤者没有出现这种变化。

第三部分：自伤行为的发生过程及干预要点。结合前文中质性研究和量化研究结果，本部分尝试对自伤行为发生的动态过程进行详细的描述，并构建自伤行为发生的理论模型。在对自伤者进行干预时，要详细了解其典型的自伤情形，关注自伤发生前的事件、感受、动机等，并需要了解其在当时的情形下为何选择自伤而非其他行为，根据这些情况来制定具体的治疗方案。

关键词：自我伤害行为；近端影响因素；发生过程；质性研究；量化研究

Abstract

Non-Suicidal Self-Injury（NSSI）is a psychopathological phenomenon that differs from suicidal behavior.Why people hurt themselves is one of the most concerned questions for the researchers of NSSI.Researchers had identified a large number of factors influencing NSSI,and also had described the process of self-injury from different perspectives.However,although these studies and theories have greatly enriched the current understanding of NSSI,such phenomenon cannot be explained:two teenagers who encounter the same difficult situation and have the same risk factors,one chooses to attack others,and the other chooses self-injury.Given such a background,this study attempts to return to the life experiences of non-suicidal self-injurers and explore which factors directly affect the individual's self-injurious behavior,and clarify the process of NSSI.Three parts were included：

Part 1:Qualitative study on the influencing factors of NSSI.This study explored the factors leading to self-injurious behaviors in the first place.Given the involvement of a large number of internal experiences,quantifying comprehensive measurements is generally difficult.Thus,this study will use the qualitative research method to carry out a thorough and comprehensive analysis of these factors.Eighteen self-injured people were selected for in-depth interviews,and the Consensual Qualitative Research（CQR）method was used to analyze the interview materials.The results showed that from the factors that affect his ultimate choice of self-injury rather than other methods can be divided into four domains:Trigger events.Mental state.Motivation.Means selection.

Part 2:Quantitative study on the key influencing factors of NSSI.The results of study 1 showed that self-injurers choose NSSI behaviors under the combined influences of many factors.Several variables appear to be highly representative and are seldom described in previous studies;these variables are high emotional intensity,advantages of NSSI,and cognitive limitations.Therefore,this research will conduct a quantitative study on the relationships between these three variables and NSSI.The results showed that:（1）self-injurers tend to choose NSSI under the condition of high emotional intensity;（2）the self injuriers showed a negative implicit attitude for NSSI,but not significantly different from other groups;（3）NSSI can help self-injurers escape from negative emotion within a shorter time than music.No significant difference between the regulation results of NSSI and those of other methods was noted;（4）there were no significant difference between self-injurers and non-self-injurers when solving social problems under high and low negative emotions.However,under the condition of high negative emotion,the self-efficacy of self-injurers in solving problems was significantly reduced while that of non-self-injurers was not.

Part 3:the process of NSSI and the points of interventions.Combining current findings with earlier results of qualitative and quantitative research,this section attempts to describe the dynamic process of NSSI and construct theoretical models of self-injurious behavior.And the therapists need to understand the situation of NSSI in detail;focus on the events,feelings,and motivations of an individual before choosing NSSI; and determine why this behavior and not some other methods are selected.When this information is known,specific therapeutic targets can be formulated.

Key Words:Non-Suicidal Self-injury; the proximal influencing factors; the process of NSSI; qualitative study; quantitative study