The Efficacy Of Mobile Phone-based Text Message Interventions For Adolescents With Non-suicidal Self-Injury Behaviors

ObjectsBy systematically reviewing relevant research on mobile text intervention and the experiential avoidance model of deliberate self-harm,the content of text messages suitable for Non-suicidal Self-injury(NSSI)Chinese adolescents was constructed.A randomized controlled trial that used text messages as treatment measures was conducted among Chinese NSSI adolescents to verify the efficacy of mobile text intervention in reducing the occurrence of NSSI behaviors and to explore the influence of mobile text intervention on the negative emotion level,emotion regulation strategies,and coping style use of NSSI adolescents.MethodsA randomized controlled trial method was used,86 NSSI adolescents recruited from the psychiatric clinics of third-class hospital were randomly divided into the intervention group or control group.The intervention group received 8 weeks of mobile text messages intervention and drug treatment as usual,while the control group received only 8 weeks of drug treatment as usual.The General Information Questionnaire,NSSI Behavioral Questionnaire,Generalized Anxiety Disorder 7-item Scale,Patient Health Questionnaire 9-item,Beck Hopelessness Scale,Emotion Regulation Questionnaire,and the Simplified Coping Style Questionnaire were used to assess NSSI behaviors and mental status between the two groups at baseline,4 weeks,and 8 weeks.SPSS 26.0 statistical software was used for data analysis,and statistical methods such as Chi-square test,Mann-Whitney U test,and Generalized Linear Mixed Model were used to compare the differences of outcome indicators between groups and time.Results(1)After 8 weeks of mobile text messages intervention,the prevalence of NSSI behaviors(c~2=6.680,P<0.05),the frequency of NSSI behaviors(Z=-2.717,P<0.05),the prevalence of NSSI ideations(c~2=4.420,P<0.05)and the frequency of NSSI ideations(Z=-2.229,P<0.05)in the intervention group were significantly lower than those in the control group.(2)After 8 weeks of mobile text messages intervention,the risk of NSSI behaviors in the intervention group was only 0.503 times(OR=0.503,95%CI=0.284-0.890)that of the control group.The risk of NSSI behaviors in both groups at week 4(OR=0.319,95%CI=0.155-0.659)and week 8(OR=0.379,95%CI=0.186-0.775)was significantly lower than before the intervention.(3)After 8 weeks of mobile text messages intervention,the total score of the Beck Hopelessness Scale(Z=-1.999,P<0.05)and the score of“feelings about the future”sub-dimension(Z=-1.987,P<0.05)in the intervention group were significantly lower than the control group.There was no significant difference in the scores of anxiety symptoms,depressive symptoms,emotion regulation strategies,and coping styles scales between the groups(P>0.05).ConclusionMobile text messaging as a new remote intervention method can significantly reduce the occurrence of NSSI behaviors and ideations in NSSI adolescents.In view of the advantages of convenience,speed,low cost,and wide coverage of the use of mobile text messages,the promotion and application of mobile text messages intervention can provide a timely,effectively and financial friendly treatment for more NSSI adolescents who do not have access to health service resources or who unwilling to receive traditional face-to-face psychotherapy.