Prevalence of Adverse Childhood Experiences and Their Associations with Non-Suicidal Self-Injury Among Chinese Adolescents with Depression

Retrospective ACEs predict complex PTSD symptoms in a large sample of Chinese young adults longitudinally: the moderating role of self-compassion

This longitudinal study in Mainland China (2021-2022) explored the impact of adverse childhood experiences (ACEs) on complex posttraumatic stress disorder (CPTSD) symptoms, with a focus on the role of self-compassion. Among 18,933 surveyed university students, 21.2% reported experiencing at least one ACE. Results revealed a clear relationship between ACEs and CPTSD symptoms. Furthermore, self-compassion, particularly the dimensions of self-judgment and isolation, moderated the association between retrospective ACEs and posttraumatic stress disorder (PTSD) and disturbance in self-organization (DSO) symptoms. These findings highlight the enduring impact of ACEs on CPTSD symptoms and emphasize the importance of early identification and targeted interventions, especially addressing self-judgment and isolation, to mitigate CPTSD risk among young Chinese adults.

Pathway from childhood trauma to nonsuicidal self-injury in adolescents with major depressive disorder: the chain-mediated role of psychological resilience and depressive severity

This study aimed to explore the pathway from childhood trauma to nonsuicidal self-injury (NSSI) in adolescents with major depressive disorder (MDD) and to examine the chain-mediating role of psychological resilience and depressive symptoms in this pathway. A total of 391 adolescents with MDD were recruited in the present study. The Chinese version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Chinese version of the Symptoms Check List-90 (SCL-90), the Chinese version of the Conner-Davidson Resilience Scale (CD-RISC), and the Ottawa Self-Injury Inventory Chinese Revised Edition (OSIC) were used to evaluate childhood trauma, depressive symptoms, psychological resilience and NSSI, respectively. Our results showed that 60.87% of adolescents with MDD had NSSI in the past month. Childhood trauma frequency was negatively correlated with psychological resilience but positively correlated with depressive symptoms and NSSI severity in adolescents with MDD. The stepwise logistic regression analysis identified that age, childhood trauma and depressive symptoms could independently predict the occurrence of NSSI, and the three-step hierarchical regression showed that childhood trauma, psychological resilience and depressive symptoms were all significantly associated with NSSI frequency in adolescents with MDD. Furthermore, the chain-mediation analysis revealed that psychological resilience and depression serially mediated the relationship between childhood trauma and NSSI in adolescents with MDD. Interventions targeted at improving resilience and depression may mitigate the impact of childhood trauma severity on NSSI risk in adolescents with MDD.

Heterogeneity in Adolescents' Non-Suicidal Self-Injury Behaviour Trajectories Based on the Group-Based Trajectory Model and a Decision Tree Analysis of Family-Related Determinants

Background

Non-suicidal self-injury (NSSI) is a global public health problem. While some studies have noted the importance of behavioural development patterns in NSSI, most NSSI research is based on cross-sectional survey data. Few studies explore the time-series heterogeneity of trajectories of NSSI symptoms and family-related influencing factors of NSSI.

Aim

The purpose of the study was to identify the heterogeneity in trajectories of adolescents' NSSI behaviour and their family-related influencing factors.

Methods

The group-based trajectory model (GBTM) was used to identify the heterogeneity in the NSSI behaviour trajectories of 208 adolescents in China. Next, the decision tree model (DTM) was used to analyse which family related factors influence the trajectory type.

Results

The GBTM revealed two heterogeneous trajectories of NSSI behaviour: the high-risk and low-risk NSSI behaviour groups. Next, DTM's average accuracy was 83.2%. A total of seven independent variables were used for the DTM: gender, number of NSSIs in the past month, and family economic, family structure, family conflict, parental psychological control, parental behavior control and family intimacy risks. Family conflict risk was located at the root node and was the most important factor.

Conclusion

Heterogeneity within the population should be considered in the management of adolescents' NSSI behaviours. Further, from the perspective of family system theory and cumulative risk, focusing on the adverse effect of multiple risk factors on adolescents' NSSI addiction is more meaningful rather than the impact of single risk factors. Studies that use time series data should focus on the trend of dynamic changes in NSSI addiction characteristics over time.

Adverse childhood experiences, unhealthy lifestyle, and nonsuicidal self-injury: findings from six universities in Shaanxi province, China

Background

Nonsuicidal self-injury (NSSI) is a serious public health problem. The role of adverse childhood experiences (ACEs) and lifestyle on the risk for NSSI is still underexplored, especially among college students. We aimed to investigate the association of ACEs with the risk of NSSI, and effect modifications by lifestyle among college students.

Methods

A total of 18,723 college students from six universities were recruited through a multistage, random cluster sampling method in Shaanxi province, China. The Adverse Childhood Experiences International Questionnaire was used to assess ACEs for each participant, and the Chinese version of the Ottawa Self-injury Inventory was used to assess the presence or absence of NSSI behaviors. Information about lifestyle was collected by a self-designed questionnaire. The associations of NSSI with ACEs and lifestyle were analyzed using logistic regression models. Furthermore, we constructed a combination score of multiple lifestyles and evaluated whether lifestyle modified the effect of ACEs on the risk of NSSI.

Results

The prevalence of NSSI for the past 1 month, 6 months, and 12 months was 3.8, 5.3, and 6.5%, respectively. 82.6% of participants have reported experiencing at least one type of ACEs, and participants with higher levels of ACEs (≥4) were more likely to have higher odds of developing NSSI during the past 1 month (OR, 4.10; 95%CI, 3.38-4.97), 6 months (OR, 4.76; 95%CI, 4.03-5.62), and 12 months (OR, 5.62; 95%CI, 4.83-6.55), as compared with participants with low levels of ACEs (0-1). There were additive interactions between ACEs and lifestyle. Compared with participants with low levels of ACEs and healthy lifestyle, participants with high levels of ACEs and unhealthy lifestyle had the highest odds of NSSI during the past 1 month (OR, 5.56; 95%CI, 3.80-8.31), 6 months (OR, 6.62; 95%CI, 4.73-9.42), and 12 months (OR, 7.62; 95%CI, 5.59-10.52).

Conclusion

These results suggest that ACEs play an important role in the occurrence of NSSI among college students, especially in those with unhealthy lifestyle. Our findings may help develop targeted intervention strategies for the prevention of NSSI.