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عنوان فارسی مقاله: | انگیزه آنی و خود آسیب زنی غیر خودکشی: مرور و فراتحلیل |
عنوان انگلیسی مقاله: | Impulsivity and nonsuicidal self-injury: A review and meta-analysis |
رشته های مرتبط: | روانشناسی، روانشناسی بالینی، سنجش و اندازه گیری یا روان سنجی |
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نشریه | الزویر – Elsevier |
کد محصول | f378 |
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بخشی از مقاله انگلیسی: ۱٫ Introduction Nonsuicidal self-injury (NSSI), which is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) as the direct and deliberate destruction of bodily tissue in the absence of suicidal intent, includes behaviors such as selfcutting, burning, hitting, and head-banging (Nock & Favazza, 2009). Among inpatient samples, as many as 21% of adults (Briere & Gil, 1998) and 30 to 45% of adolescents engage in NSSI (Cloutier, Martin, Kennedy, Nixon, & Muehlenkamp, 2010; Darche, 1990). Estimates of NSSI prevalence in the community also are concerning, with as many as 13 to 38% of adolescents and young adults reporting lifetime histories of NSSI (Gratz, Conrad, & Roemer, 2002; Hamza, Willoughby, & Good, 2013; Heath, Toste, Nedecheva, & Charlebois, 2008; Whitlock, Muehlenkamp, & Eckenrode, 2008). Given the widespread prevalence of NSSI, understanding risk factors for NSSI engagement has become an important priority. One risk factor for NSSI that has received increasing empirical attention is impulsivity. NSSI has long been considered as a behavior associated with impulse control problems (i.e., acting rashly with little thinking or planning; Favazza & Conterio, 1989). Before being added as its own condition in the DSM-5, NSSI formerly was regarded as a symptom of Borderline Personality Disorder (BPD; American Psychiatric Association, 2013). A critical feature of BPD is impairment in impulse control (Evren, Cinar, Evren, & Celik, 2012; Lieb, Zanarini, Schmahl, Linehan, & Bohus, 2004). Despite past conceptualizations of NSSI as an impulsive behavior, however, recent empirical work on the link between impulsivity and NSSI has offered mixed findings. In the present review, we provide an extensive overview of studies that have examined the association between impulsivity and NSSI. Next, discrepancies in findings between studies using self-report and experimental measures of impulsivity are highlighted. Finally, findings are integrated and several recommendations for future research are offered. ۲٫ Impulsivity The term impulsivity has been described by researchers as an umbrella term that broadly encompasses a variety of traits, such as sensation-seeking, lack of planning, novelty seeking, lack of delay of gratification, and adventuresomeness (Costa & McCrae, 1992; Depue & Collins, 1999; Eysenck & Eysenck, 1977; Fischer, Smith, & Cyders, 2008; Glenn & Klonsky, 2010; Mullins-Sweatt, Lengel, & Grant, 2013). Many studies have implicated impulsivity in problem behavior engagement, such as alcohol use, drug use, disordered eating and other risky behaviors (Fischer, Anderson, & Smith, 2004; Heaven, Mulligan, Merrilees, Woods, & Fairooz, 2001; Lejuez et al., 2010; Perry & Carroll, 2008; Poulos, Le, & Parker, 1995). Inconsistency across studies in conceptualizations of impulsivity, however, makes it difficult to disentangle which aspects or facets of impulsivity are most closely associated with problem behavior engagement (including engagement in NSSI; Depue & Collins, 1999; Whiteside & Lynam, 2001). Many predominant theories of personality and psychopathology have underscored the role of a variety of impulsivity-related traits in the prediction of behavior (for a review, see Pickering & Gray, 1999 or Whiteside & Lynam, 2001). In their well-known theory of personality, Eysenck and Eysenck (1985) proposed that impulsivity consists of two factors: 1) venturesomeness (e.g., risk-taking, openness to new and exciting experiences) and 2) impulsiveness (e.g., acting without thinking; also see Eysenck, Pearson, Easting, & Allsopp, 1985), which make up lower-order dimensions of their three primary personality factors (i.e., neuroticism, extraversion, psychoticism). Venturesomeness was conceptualized by researchers as a lower-order dimension of extraversion, and impulsiveness was regarded as a lower-order dimension of psychoticism (Eysenck & Eysenck, 1985). In their model of temperament, Pickering and Gray (1999) suggested that impulsivity-related traits stem from sensitivity in the behavioral activation system (BAS) of the brain, resulting in high levels of approach-seeking behaviors, particularly sensation seeking. In contrast, other theories have primarily conceptualized impulsivity as the tendency to act without thinking (e.g., Buss & Plomin, 1975). Two research groups have attempted to integrate past conceptualizations of impulsivity to create a more unified construct. Baratt and colleagues (Barratt, 1993; Patton, Standford, & Barratt, 1995) developed a measure to assess what they proposed to be three central impulsivity factors: 1) motor impulsivity (acting without thinking), 2) nonplanning impulsivity (i.e., failure to plan ahead, “present focused”), and 3) attentional impulsivity (rapid decision making; BIS, Patton et al., 1995). Validation studies supported Barratt et al.’s three factors (Barratt, 1993; Patton et al., 1995), although some researchers only found support for two of the three factors (Luengo, Carrillo-De-La-Pena, & Otero, 1991). To further advance the field, Whiteside and Lynam (2001) conducted a large factor analysis on the predominant measures assessing impulsivity (e.g., Barratt Impulsiveness Scale, Patton et al., 1995; Personality Research Form Impulsivity Scale, Jackson, 1984; Sensation-Seeking Scale, Zuckerman, 1984). Four primary facets were identified that mapped onto the Five-Factor Model of personality (FFM, Costa & McCrae, 1992). The four factors included: 1) negative urgency (i.e., acting rashly in the context of negative emotions, 2) lack of premeditation (i.e., acting rashly with little thinking, planning or consideration of consequences), 3) lack of perseverance (i.e., inability to continue or remained focused on a difficult or boring task), 4) and sensation seeking (i.e., a predilection for novel or exciting experiences). Negative urgency was associated with neuroticism from the FFM, lack of perseverance and premeditation were associated with conscientiousness, and sensation seeking was aligned with openness to new experiences. On the basis of these findings, Whiteside and Lynam concluded that impulsivity is a heterogeneous measure that encompasses several lower-order personality traits which lead to impulsive behavior. Thus, Whiteside and Lynam urged that researchers should be explicit about the specific facets of self-reported impulsivity assessed in their studies (also see Smith et al., 2007). Researchers also have employed lab-based measures of impulsivity to assess state impulsivity (i.e., at the time of measurement; Dick et al., 2010). Lab-based measures tend to assess five primary dimensions of impulsivity: 1) prepotent response inhibition (i.e., the ability to suppress one’s dominant response), 2) resistance to distractor interference (i.e., difficulty in ignoring a distraction that interferes with the task), 3) resistance to proactive interference (i.e., difficulty ignoring memory intrusions of irrelevant information that interferes with thetask), 4) delay response (i.e., difficulty delaying immediate gratification for long-term gain) and 5) distortions in elapsed time (i.e., difficulty in determining how much time has elapsed; Dick et al., 2010; Cyders & Coskunpinar, 2011). Lab-based measures of impulsivity (e.g., Go/NoGo Task, immediate and delayed memory tasks, Stop/Signal Task) tend to be only moderately associated with self-report measures of impulsivity (Dougherty & Marsh, 2003; Logan & Cowan, 1984; Newman & Kosson, 1986). For example, when Cyders and Coskunpinar (2012) examined correlations among self-reported UPPS impulsivity traits and the five predominant measures of impulsivity assessed in lab-tasks, delay responding was moderately correlated with the different facets of impulsivity assessed by the UPPS, and prepotent response inhibition was modestly correlated with negative urgency and lack of perseverance. These findings suggest that researchers should not only be explicit about facets of impulsivity assessed, but also be careful about generalizing findings from self-report measures of impulsivity to lab-based assessments. In recent years, Whiteside and Lynam’s (2001) four impulsive traits (i.e., negative urgency, lack of premeditation, lack of perseverance, sensation seeking), have been widely adopted by researchers, and supported by findings on the validity of the UPPS measure (Cyders et al., 2007; Smith et al., 2007; for a review, see Cyders, 2013). Recent research has shown that each of these four constructs seems to be differentially related to problem behavior engagement (Curcio & George, 2011; Smith et al., 2007). In a test of the discriminating ability of the UPPS, researchers found that negative urgency was most strongly associated with problem drinking, problem gambling and binge eating, while sensation seeking was more strongly associated with frequency of drinking (Smith et al., 2007; see Coskunpinar, Dir & Cyders, 2013 for the same findings using a meta-analytic approach). Similarly, in their meta-analytic review of the literature on impulsivity and bulimic symptoms, Fischer et al. (2008) found that negative urgency was by far the most strongly associated UPPS trait with bulimic symptoms. On the basis of these findings, researchers have suggested that negative urgency may be especially relevant to the study of psychopathology, because individuals who experience highly distressing affective situations may be especially motivated to engage in problem coping behaviors to provide immediate relief from distress (Cyders & Smith, 2008; Smith et al., 2007). |