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

作　　者：何山 吕钦谕[1,2] 易正辉 HE Shan;LÜQinyu;YI Zhenghui(Department of Psychiatry,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Department of Psychiatry,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[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

出　　处：《上海交通大学学报（医学版）》2024年第4期518-524,共7页Journal of Shanghai Jiao tong University:Medical Science

基　　金：科技创新2030—“脑科学与类脑研究”重大项目(2022ZD0208500)。

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。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.

关 键 词：青少年 非自杀性自伤 执行功能障碍 神经机制 

分 类 号：R749.4[医药卫生—神经病学与精神病学]