RESUMEN
BACKGROUND: The incidence of non-suicidal self-injury (NSSI) has been on the rise in recent years. Studies have shown that people with NSSI have difficulties in emotion regulation and cognitive control. In addition, some studies have investigated the cognitive emotion regulation of people with NSSI which found that they have difficulties in cognitive emotion regulation, but there was a lack of research on cognitive emotion regulation strategies and related neural mechanisms. METHODS: This study included 117 people with NSSI (age = 19.47 ± 5.13, male = 17) and 84 non-NSSI participants (age = 19.86 ± 4.14, male = 16). People with NSSI met the DSM-5 diagnostic criteria, and non-NSSI participants had no mental or physical disorders. The study collected all participants' data of Cognitive Emotion Regulation Questionnaire (CERQ) and functional magnetic resonance imaging (fMRI) to explore the differences in psychological performance and brain between two groups. Afterwards, Machine learning was used to select the found differential brain regions to obtain the highest correlation regions with NSSI. Then, Allen's Human Brain Atlas database was used to compare with the information on the abnormal brain regions of people with NSSI to find the genetic information related to NSSI. In addition, gene enrichment analysis was carried out to find the related pathways and specific cells that may have differences. RESULTS: The differences between NSSI participants and non-NSSI participants were as follows: positive refocusing (t = -4.74, p < 0.01); refocusing on plans (t = -4.11, p < 0.01); positive reappraisal (t = -9.22, p < 0.01); self-blame (t = 6.30, p < 0.01); rumination (t = 3.64, p < 0.01); catastrophizing (t = 9.10, p < 0.01), and blaming others (t = 2.52, p < 0.01), the precentral gyrus (t = 6.04, pFDR < 0.05) and the rolandic operculum (t = -4.57, pFDR < 0.05). Rolandic operculum activity was negatively correlated with blaming others (r = -0.20, p < 0.05). Epigenetic results showed that excitatory neurons (p < 0.01) and inhibitory neurons (p < 0.01) were significant differences in two pathways, "trans-synaptic signaling" (p < -log108) and "modulation of chemical synaptic transmission" (p < -log108) in both cells. CONCLUSIONS: People with NSSI are more inclined to adopt non-adaptive cognitive emotion regulation strategies. Rolandic operculum is also abnormally active. Abnormal changes in the rolandic operculum of them are associated with non-adaptive cognitive emotion regulation strategies. Changes in the excitatory and inhibitory neurons provide hints to explore the abnormalities of the neurological mechanisms at the cellular level of them. Trial registration number NCT04094623.
Asunto(s)
Regulación Emocional , Imagen por Resonancia Magnética , Conducta Autodestructiva , Humanos , Conducta Autodestructiva/psicología , Conducta Autodestructiva/fisiopatología , Masculino , Femenino , Regulación Emocional/fisiología , Adulto , Adulto Joven , Adolescente , Cognición/fisiología , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Encuestas y CuestionariosRESUMEN
Background: The effectiveness of computerized cognitive behavioral therapy (CCBT) has been proven for mild and moderate anxiety and depression. In 2016, the first official Chinese CCBT system was launched by Chinese Cognitive Behavior Therapy Professional Organizations and included four items: getting out of depression, overcoming anxiety, staying away from insomnia and facing Obsessive-compulsive disorder. During the COVID-19 epidemic, Chinese CCBT system served the public for free. This study explored the effects of CCBT on anxiety and depression by comparing the use of the platform during the epidemic and during the same period in 2019. Methods: Users were divided into a depression group or an anxiety group according to their own discretion. The subjects used the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) before each training. Each training group completed the corresponding CCBT training project, which had 5-6 training sessions, an average of once every 5 days. The training content in 2019 and 2020 was identical. This study compared the demographic characteristics, depression, and anxiety levels of CCBT platform users during the lockdown period in Wuhan (LP2020), where the outbreak was concentrated in China, from January 23 to July 23, 2020 and the same period in 2019 (SP2019). Result: (1) There were significant differences in gender (χ2 = 7.215, P = 0.007), region (χ2 = 4.225, P = 0.040) and duration of illness (χ2 = 7.867, P = 0.049) between the two periods. (2) There was a positive Pearson correlation between the number of users of CCBT platform during LP2020 and number of confirmed cases of COVID-19 in each province (r = 0.9429, P < 0.001). (3) In LP2020, the SAS (t = 2.579, P = 0.011) and SDS (t = 2.894, P = 0.004) scores at T0 in Hubei were significantly higher than those in other regions. (4) The CCBT platform has an obvious effect on anxiety (F = 4.74, P = 0.009) and depression on users (F = 4.44, P = 0.009). Conclusion: This study showed women, students and people who are more seriously affected by the epidemic were more likely to accept the CCBT training. The CCBT platform made a significant contribution toward alleviating the anxiety and depression symptoms of users during the epidemic. When face-to-face psychotherapy is not available during the epidemic, CCBT can be used as an effective alternative.