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Li R, Deng R, Song T, Xiao Y, Wang Q, Fang Z, Huang Y, Jiao F, Chen Y. Gender-specific factors of suicidal ideation among high school students in Yunnan province, China: A machine learning approach. J Affect Disord 2024; 364:157-166. [PMID: 39147147 DOI: 10.1016/j.jad.2024.08.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/04/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Suicidal ideation (SI) assumes a pivotal role in predicting suicidal behaviors. The incidence of SI among high (junior and senior) school students is significantly higher than that of other age groups. The aim of this study is to explore the gender differences in SI among high school students in Yunnan Province. METHOD A total of 6180 students in grades 7-12 in Yunnan province, China from May 2021 to May 2022 participated in this survey. Univariate analysis was employed to describe the influencing factors of male and female students' SI. Subsequently, data were stratified by gender. Adopting machine learning technique, including Least Absolute Shrinkage and Selection Operator (Lasso) and Boruta algorithm, and logistic regression model to estimate the direction and effect magnitude of the influencing factors. RESULTS The prevalence of SI was significantly higher for females (31.34 %) than males (16.73 %). The logistic regression model was established using the variables screened by Boruta algorithm, indicated that anxiety, depression, suffering emotion abuse or emotion neglect in childhood, non-suicidal self-injury, evening chronotype are common risk factors for SI in male and female students. Notably, female students who exhibited aggressive behavior, have experienced bullying, and were in the junior high school learning stage were more likely to report SI than their male counterparts. CONCLUSIONS Females showed more vulnerability to SI than males especially among females in junior high school, reporting aggressive behavior and bullying experiences. Tailored prevention strategies, informed by these gender-related distinctions, should be developed and implemented.
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Affiliation(s)
- Ruiyu Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Rui Deng
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Ting Song
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Yan Xiao
- Foreign Languages Department, Kunming Medical University, Yunnan 650500, China
| | - Qi Wang
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Zhijie Fang
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Yuan Huang
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Feng Jiao
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China.
| | - Ying Chen
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China.
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Zhou Q, Liang Y, Gao Y, Liu X. Social Support and Non-Suicidal Self-Injury in Adolescents: The Differential Influences of Family, Friends, and Teachers. J Youth Adolesc 2024:10.1007/s10964-024-02066-8. [PMID: 39127815 DOI: 10.1007/s10964-024-02066-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
Non-suicidal self-injury (NSSI) is common among adolescents and is associated with a range of detrimental consequences. Family, teachers, and friends are essential sources of social support for adolescents. Increased social support from these sources may reduce NSSI behaviors among adolescents. However, it is uncertain if each source of social support retains its significance when their influences are evaluated simultaneously, and how each source influences the others to impact NSSI behaviors. To address this gap, this research investigated the direct and indirect effects of each source of social support on adolescent NSSI using cross-lagged panel model (CLPM), as well as whether these relationships varied by sex. A total of 3098 Chinese adolescents with a range of 10 to 15 years old (Mage = 13.27, SD = 0.73, 42.4% girls) completed assessments on three waves across approximately two years. The results indicated that teacher support compared to family and friend support showed the strongest association with NSSI behaviors and mediated the relationship between family support and NSSI. These findings highlight teacher support as a hub in the role of social support on NSSI and emphasize the importance of the connections between teacher and family support.
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Affiliation(s)
- Quan Zhou
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yiting Liang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.
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Zhou L, Qiao C, Huang J, Lin J, Zhang H, Xie J, Yuan Y, Hu C. The Impact of Recent Life Events, Internalizing Symptoms, and Emotion Regulation on the Severity of Non-Suicidal Self-Injury in Adolescents: A Mediation Analysis. Neuropsychiatr Dis Treat 2024; 20:415-428. [PMID: 38469207 PMCID: PMC10926171 DOI: 10.2147/ndt.s444729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024] Open
Abstract
Background Previous studies have demonstrated a strong association between recent stressful life events and non-suicidal self-injury (NSSI) among adolescents. Internalizing symptoms and difficulty in emotion regulation (DER) may mediate this relationship. This study aimed to investigate the relationship between recent stressful life events and NSSI severity in adolescents and the potential moderating role of internalizing symptoms and DER. Methods A total of 224 adolescent inpatients (78.6% female) participated in the study, with an age range of 12-18 years old. Data on recent stressful life events, internalizing symptoms, DER, and NSSI behaviors were collected using a clinician-rated questionnaire. A structural equation model was used to test the hypothesized model. Results The rate of NSSI reporting among adolescents in the past 12 months was 65.18%. Recent stressful life events were found to be directly associated with NSSI severity (β = 0.128, P = 0.023). A chain-mediating effect between recent stressful life events and NSSI was also confirmed (β = 0.034, P = 0.023), with DER and internalizing symptoms playing a chain-mediating role and DER having a significantly indirect association with NSSI through internalizing symptoms. Conclusion Recent stressful life events appear to play a role in the etiology of NSSI, particularly punishment and interpersonal relationship events that warrant special attention. DER and internalizing symptoms play a chain-mediating role in the relationship between life events and NSSI. Reducing recent stressful life events, screening for internalizing symptoms, and improving emotion regulation may decrease NSSI behavior among adolescents.
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Affiliation(s)
- Linqi Zhou
- School of the Fourth Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Changyuan Qiao
- School of the Fourth Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Jialing Huang
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Jian Lin
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Haisheng Zhang
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Jian Xie
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Changchun Hu
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
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Guo X, Wu S, Dong W, Zhang Y, Su Y, Chen C. The Effect of Bullying Victimization on Adolescent Non-Suicidal Self-Injury: The Mediating Roles of Alexithymia and Self-Esteem. Psychol Res Behav Manag 2024; 17:783-797. [PMID: 38444719 PMCID: PMC10911978 DOI: 10.2147/prbm.s450195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
Background & Aim Non-suicidal self-injury (NSSI) in adolescents is a serious public health issue influenced by the interaction of multiple factors. The purpose of this study was to investigate the multiple mediating roles of alexithymia and self-esteem in the association between bullying victimization and NSSI in a sample of Chinese adolescents. Methods A survey of 1299 adolescents from two public middle schools in Henan Province, China, was undertaken. Data were collected using the Chinese version of the Delaware bullying victimization scale-student (DBVS-S), the Toronto Alexithymia-20 Scale (TAS-20-C), the Rosenberg self-esteem scale (RSES), and the adolescent self-injury questionnaire. Besides, we performed a structural equation modeling (SEM) with latent variables using AMOS 26.0 to examine the relationship between variables and the mediating effects. Results The SEM analysis found that not only can bullying victimization directly impact NSSI, but that alexithymia and self-esteem have a chain mediating effect in the association between bullying victimization and NSSI. This mediating effect contributed 22.47% to the total effect. Conclusion These findings validate bullying victimization, alexithymia, and low self-esteem are important variables that affect NSSI among Chinese adolescents. Educators need to implement some prevention and intervention strategies to ameliorate the campus atmosphere and adolescents' mental health aimed at avoiding NSSI behavior in adolescence.
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Affiliation(s)
- Xiajun Guo
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Sijia Wu
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Wanglin Dong
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Yiqiu Zhang
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Yue Su
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Chaoran Chen
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
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Drubina B, Kökönyei G, Várnai D, Reinhardt M. Online and school bullying roles: are bully-victims more vulnerable in nonsuicidal self-injury and in psychological symptoms than bullies and victims? BMC Psychiatry 2023; 23:945. [PMID: 38098002 PMCID: PMC10722836 DOI: 10.1186/s12888-023-05341-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/02/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Bullying leads to adverse mental health outcomes and it has also been linked to nonsuicidal self-injury (NSSI) in community adolescents. It is not clear whether different roles of bullying (bully, victim, bully-victim) are associated with NSSI, furthermore the same associations in cyberbullying are even less investigated. METHODS The aim of the current study was to test whether students involved in school or online bullying differed from their not involved peers and from each other in psychological symptoms (externalizing and internalizing problems) and in NSSI severity (number of episodes, number of methods). Furthermore, mediation models were tested to explore the possible role of externalizing and internalizing problems in the association of school and online bullying roles with NSSI. In our study, 1011 high school students (66.07% girls; n = 668), aged between 14 and 20 years (Mage = 16.81; SD = 1.41) participated. RESULTS Lifetime prevalence of at least one episode of NSSI was 41.05% (n = 415). Students involved in bullying used more methods of NSSI than not involved adolescents. In general, victim status was associated mostly with internalizing symptoms, while bully role was more strongly associated with externalizing problems. Bully-victims status was associated with both types of psychological problems, but this group did not show a significantly elevated NSSI severity compared to other bullying roles. Externalizing and internalizing problems mediated the relationship between bullying roles and NSSI with different paths at different roles, especially in case of current NSSI that happened in the previous month. CONCLUSIONS Results highlight that students involved in bullying are more vulnerable to NSSI and to psychological symptoms compared to their peers who are not involved in bullying. It is suggested that bullying roles, especially bully-victim status, need to be identified in school and online settings and thus special attention should be addressed to them to reduce psychological symptoms and NSSI, for example by enhancing adaptive coping skills.
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Affiliation(s)
- Boglárka Drubina
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Dóra Várnai
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Heim Pál National Institute of Pediatrics, Budapest, Hungary
| | - Melinda Reinhardt
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- 14th District Medical Center, Child and Adolescent Psychiatry, Budapest, Hungary
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Yu H, Mu Q, Li K. Effects of physical exercise on non-suicidal self-injury in adolescents: the chain mediating role of perceived social support and self-concept. Front Psychiatry 2023; 14:1201863. [PMID: 37876620 PMCID: PMC10591106 DOI: 10.3389/fpsyt.2023.1201863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Objective To study the effect of physical exercise on non-suicidal self-injury in adolescents and to verify the chain mediating role of perceived social support and self-concept. Methods: A survey study was conducted on 1,426 adolescents in Chengdu, Sichuan Province. A chain mediation model was used to verify whether perceived social support and self-concept played a mediating role. Results Physical exercise was significantly negatively associated with non-suicidal self-injury in adolescents (β = -0.53, p < 0.01) and significantly positively associated with perceived social support and self-concept (β = 0.52, 0.54, p < 0.01), and perceived social support and self-concept were significantly negatively associated with non-suicidal self-injury (β = -0.59, p < 0.01; β = -0.64, p < 0.01), and perceived social support was able to significantly and positively associate self-concept (β = 0.76, p < 0.01). Conclusion Perceived social support and self-concept play a chain mediating role in the effect of physical exercise on non-suicidal self-injury in adolescents, and it is recommended that the development of perceived social support and self-concept be emphasized during adolescents' development, which has the potential to reduce the incidence of non-suicidal self-injurious behaviors in adolescents.
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Affiliation(s)
- Haoran Yu
- Institute of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
| | - Qinglei Mu
- Institute of Physical Education, Chengdu University, Chengdu, Sichuan, China
| | - Ke Li
- Institute of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
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Wang TW, Gong J, Wang Y, Liang Z, Pang KL, Wang JS, Zhang ZG, Zhang CY, Zhou Y, Li JC, Wang YN, Zhou YJ. Differences in Non-suicidal Self-injury Behaviors between Unipolar Depression and Bipolar Depression in Adolescent Outpatients. Curr Med Sci 2023; 43:998-1004. [PMID: 37558867 DOI: 10.1007/s11596-023-2772-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/24/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) has a higher prevalence in adolescents with depressive disorders than in community adolescents. This study examined the differences in NSSI behaviors between adolescents with unipolar depression (UD) and those with bipolar depression (BD). METHODS Adolescents with UD or BD were recruited from 20 general or psychiatric hospitals across China. The methods, frequency, and function of NSSI were assessed by Functional Assessment of Self-Mutilation. The Beck Suicide Ideation Scale was used to evaluate adolescents' suicidal ideation, and the 10-item Kessler Psychological Distress Scale to estimate the anxiety and depression symptoms. RESULTS The UD group had higher levels of depression (19.16 vs.17.37, F=15.23, P<0.001) and anxiety symptoms (17.73 vs.16.70, F=5.00, P=0.026) than the BD group. Adolescents with BD had a longer course of NSSI than those with UD (2.00 vs.1.00 year, Z=-3.39, P=0.001). There were no statistical differences in the frequency and the number of methods of NSSI between the UD and BD groups. Depression (r=0.408, P<0.01) and anxiety (r=0.391, P<0.01) were significantly and positively related to NSSI frequency. CONCLUSION Adolescents with BD had a longer course of NSSI than those with UD. More importantly, NSSI frequency were positively and strongly correlated with depression and anxiety symptoms, indicating the importance of adequate treatment of depression and anxiety in preventing and intervening adolescents' NSSI behaviors.
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Affiliation(s)
- Ting-Wei Wang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, 518000, China
| | - Jian Gong
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Yang Wang
- College of Management, Shenzhen University, Shenzhen, 518000, China
| | - Zhen Liang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, 518000, China
| | - Ke-Liang Pang
- School of Pharmaceutical Sciences, IDG/McGovern Institute for Brain Research, Tsinghua University-Peking University Joint Center for Life Sciences, Tsinghua University, Beijing, 100000, China
| | - Jie-Si Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100000, China
| | - Zhi-Guo Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, 518000, China
| | - Chun-Yan Zhang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, 518000, China
| | - Yue Zhou
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Jun-Chang Li
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, 518000, China
| | - Yan-Ni Wang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China.
| | - Yong-Jie Zhou
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, 518000, China.
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Farkas BF, Takacs ZK, Kollárovics N, Balázs J. The prevalence of self-injury in adolescence: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02264-y. [PMID: 37486387 DOI: 10.1007/s00787-023-02264-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
In the past 10 years, there has been a growing interest in self-injurious behavior (SIB) among adolescents. The lifetime prevalence of SIB is between 16 and 22% in community sample with females more likely to engage in SIB. There are conflicting results about the global distribution of the prevalence of SIB and whether the SIB has increased in the 21st century. Our aim in the current study was to conduct a systematic search of and meta-analysis on the prevalence of SIB in adolescents over the past 5 years' worth of published papers and to examine gender, continental, and year differences. We conducted a systematic search in June 2020 of six databases (PubMed, Scopus, Web of Science, OVID Medline, PsycINFO, EBSCO) with three main search terms: "self-injurious behavior," "prevalence," and "adolescence." Article inclusion criteria were (a) written in English; (b) published between January 1, 2015, and June 18, 2020; and (c) focused on a community sample. Titles and abstracts of the articles were screened first. Then, the relevant full texts were read, and those that met the inclusion criteria were collected. We used Comprehensive Meta-Analysis software was used to conduct the analyses. After the screening process 97, articles were included in the meta-analysis. The age of the samples ranged from 11.00 to 18.53 years. The overall average prevalence of nonsuicidal self-injury in the studies was 16%. There was a significant gender difference: females reported a higher prevalence than males (19.4% and 12.9%, respectively). A significantly higher prevalence was found among Asian articles than those from other continents (19.5% and 14.7%, respectively). The prevalence of SIB did not change significantly between 2013 and 2018. The current research draws attention to the high prevalence of SIB among adolescents, especially among females and those living in Asia. It is important to address this behavior, both in terms of prevention and intervention.
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Affiliation(s)
| | - Zsofia K Takacs
- Faculty of Education and Psychology, Institute of Education, Eötvös Loránd University, Budapest, Hungary
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK
| | - Nóra Kollárovics
- Mental Health Sciences Doctoral School, Semmelweis University, Budapest, Hungary
| | - Judit Balázs
- Department of Developmental and Clinical Child Psychology, Faculty of Education and Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Oslo New University College, Oslo, Norway
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Association between Negative Life Events and Somatic Symptoms: A Mediation Model through Self-Esteem and Depression. Behav Sci (Basel) 2023; 13:bs13030243. [PMID: 36975269 PMCID: PMC10045670 DOI: 10.3390/bs13030243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/19/2023] [Accepted: 03/05/2023] [Indexed: 03/14/2023] Open
Abstract
The purpose of this study was to investigate the serial multiple mediation of self-esteem and depression in the relationship between negative life events and somatic symptoms in Chinese medical students. We recruited a total of 3383 medical students for this study, and used the Patient Health Questionnaire-15 to assess the somatic symptoms of subjects; the Adolescent Self-Rating Life Events Check List to assess negative life events; the Rosenberg Self-Esteem Scale to assess self-esteem; and the Patient Health Questionnaire for depression. Descriptive analysis and statistical tests were then performed on the collected data. We showed that 39.17% of the medical students had mild somatic symptoms, 24.14% had moderate somatic symptoms, and 5.66% had severe somatic symptoms; we observed significant differences in somatic symptoms among genders, living expenses, and one-child. For negative life events, interpersonal stress was the most important predictor of somatization during the regression analysis. In addition, we observed significance for both the direct and part of the indirect paths from negative life events to somatic symptoms using mediation model analysis. However, we noted that there was no significance for the path through negative life events and self-esteem to somatic symptoms. This study revealed a high prevalence of somatic symptoms among Chinese medical students, and the findings suggested that interventions aimed at reducing somatization in this population should consider the impact of negative life events, particularly those related to interpersonal stress. One potential approach to mitigating the effects of negative life events on somatization is to enhance self-esteem and decrease the level of depression among medical students.
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Xin M, Zhang L, Yang C, Yang X, Xiang M. Risky or protective? Online social support's impact on NSSI amongst Chinese youth experiencing stressful life events. BMC Psychiatry 2022; 22:782. [PMID: 36510160 PMCID: PMC9743110 DOI: 10.1186/s12888-022-04399-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study was designed to investigate potential gender differences in the interrelations between different types of stressful life events and non-suicidal self injury (NSSI) among Chinese youth, as well as to test the direct and moderating impacts of online social support on Chinese students' NSSI engagement under the pressure of different types of stressful life events. METHODS Based on the data of 2200 students from middle - highschools and universities in Northwestern China, gender difference (male/female binary) in stressful life events, online social support, NSSI and their correlations were analyzed in the study. RESULTS Among different types of stressful life events, male students were reported to experience a significantly higher impact of punishment and interpersonal relationship than females. Female students only experienced significantly higher learning pressure than males; Gender difference was not indentified in NSSI among youth; Stressful life events related to punishment could significantly predict NSSI engagement among males. Stressful life events related to learning pressures, interpersonal relationships, and adaption were significantly correlated to NSSI engagement among females; Online social support didn't had a significant direct effect on youth's NSSI, although it did significantly moderate the relationship between specific types of stressful life events (i.e., loss, interpersonal relationships, adaption among males and all types among females) and their NSSI. CONCLUSION The present study has provided evidence of specified types of stressful life events being risk factors in affecting youth's NSSI: For male students, the higher impacts of stressful life events related to punishment they experienced, the more likely they were about to engage in NSSI. For female students, stressful life events related to learning pressure, interpersonal relationships and adaption were all proved as significant predictors and risky factors of female youth's NSSI; Online social support did not impact on individual's NSSI engagement directly, but moderated it significantly as a protective factor.
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Affiliation(s)
- Moye Xin
- School of Psychology, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China. .,Shaanxi Key Research Center for Children Mental and Behavioral Health, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China. .,Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Normal University, Xi'an, Shaanxi, China.
| | - Lijin Zhang
- School of Psychology, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China.,Shaanxi Key Research Center for Children Mental and Behavioral Health, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China.,Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Chengxi Yang
- College of Liberal Arts, Yulin University, No. 51, Chongwen Road, Yulin, 719000, China
| | - Xueyan Yang
- The Institute for Population and Develoment Studies, Xi'an Jiaotong University, Xi'an, No. 28 Xianning West Road, Xi'an, 710049, China
| | - Meiqiu Xiang
- School of Psychology, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China.,Shaanxi Key Research Center for Children Mental and Behavioral Health, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China.,Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Normal University, Xi'an, Shaanxi, China
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11
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Chen Z, Li J, Liu J, Liu X. Adverse childhood experiences, recent negative life events, and non-suicidal self-injury among Chinese college students: the protective role of self-efficacy. Child Adolesc Psychiatry Ment Health 2022; 16:97. [PMID: 36463208 PMCID: PMC9719251 DOI: 10.1186/s13034-022-00535-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a severe health problem closely related to adverse childhood experiences (ACEs). However, the underlying mechanisms by which ACEs may affect NSSI are largely unknown. Self-efficacy (NSSI-SE) and recent negative life events (RNLEs) may play important roles in this relationship. This study aimed to clarify the relationship between ACEs and NSSI among college students by examining the role of self-efficacy (NSSI-SE) and RNLEs in this process. METHOD Relevant self-report questionnaires were used to evaluate ACEs, RNLEs, NSSI-SE, and NSSI. A questionnaire of 1036 Chinese undergraduates (Mage = 19.65, 28.9% males, 71.1% females) was collected in a cross-sectional manner. The associations between ACEs, RNLEs, NSSI-SE and NSSI were assessed using Pearson correlation analyses. Then, hierarchical multiple linear regressions were used to analyze the effects of ACEs and RNLEs on NSSI, as well as the protective effect of NSSI-SE on the above relations. RESULTS NSSI was associated with both ACEs and RNLEs. ACEs and RNLEs could directly increase the risks of participating in NSSI, and the effects of ACEs and RNLEs on NSSI were independent without an interactive effect. NSSI-SE buffered the relationship between ACEs and NSSI, as well as between RNLEs and NSSI. Compared to individuals with a low level of NSSI-SE, ACEs and RNLEs were not significantly associated with NSSI in persons with a high level of NSSI-SE. CONCLUSION NSSI-SE may buffer the effect of ACEs and RNLEs on NSSI, indicating that future interventions can be enhanced by targeting NSSI-SE among college students with ACEs or RNLEs to prevent their engagement in NSSI.
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Affiliation(s)
- Zixun Chen
- grid.260474.30000 0001 0089 5711School of Education Science, Nanjing Normal University, No. 122 Ninghai Road, Gulou District, Nanjing, 210097 Jiangsu China
| | - JinWen Li
- grid.20513.350000 0004 1789 9964Institute of Developmental Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875 China
| | - JinMeng Liu
- grid.20513.350000 0004 1789 9964Institute of Developmental Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875 China
| | - Xia Liu
- Institute of Developmental Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, China.
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12
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Jiang Z, Wang Z, Diao Q, Chen J, Tian G, Cheng X, Zhao M, He L, He Q, Sun J, Liu J. The relationship between negative life events and non-suicidal self-injury (NSSI) among Chinese junior high school students: the mediating role of emotions. Ann Gen Psychiatry 2022; 21:45. [PMID: 36403014 PMCID: PMC9675228 DOI: 10.1186/s12991-022-00423-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/12/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Adolescent non-suicidal self-injury (NSSI) is common and adolescence is the most common period of first self-injury, and the occurrence of NSSI is influenced by negative life events and emotional symptoms. The mediating role of emotional symptoms in the interaction between negative life events and NSSI has not been carefully investigated yet. METHODS For middle school students in three schools in a Chinese province, the Adolescents Self-Harm Scale was used to investigate NSSI, the Adolescent Self-Rating Life Events Check List was used to investigate adolescent negative life events, and the Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to assess their emotional symptoms. After the description of general data and the test for differences between groups, the relationship between negative life events, emotional symptoms and NSSI was analyzed using Pearson correlation analysis. Structural equation modeling was used to analyze the mediating role of emotions in negative life events and NSSI. RESULTS A total of 2376 junior high school students completed this survey, which revealed an annual NSSI prevalence of 37.1% (n = 881) and a higher prevalence of NSSI among girls and rural adolescents. Among adolescents who developed NSSI, 67.4% (N = 594) used multiple means of self-injury. The most common means of self-injury was hair pulling (51.0%), and the most common NSSI purpose and external factors/events were venting bad emotions or feelings (57.5%) and poor academic performance (44.9%), respectively. Negative life events, emotional symptoms and NSSI were positively associated (P < 0.05). Structural equation modeling with negative life events, emotional symptoms and NSSI as variables showed that the model-fit index matched the data well, with RMSEA = 0.073, AGFI = 0.945, GFI = 0.980, CFI = 0.985, NFI = 0.982, TLI = 0.968, IFI = 0.985, and negative life events, emotional symptoms (anxiety, depression) and NSSI all had direct effects with standardized path coefficients of 0.16, 0.19, and 0.23, respectively, with negative life events playing an indirect role in NSSI through emotional symptoms and emotional symptoms playing an incomplete mediating role in negative life events and NSSI. CONCLUSION The prevalence of NSSI was higher among Chinese junior high school students. Both negative life events and emotional symptoms were direct risk factors for NSSI. In addition, negative life events were also indirect risk factors for NSSI, and emotional symptoms played an incomplete mediating role in the relationship between the effects of negative life events and NSSI. This indicates that the combination of reducing the frequency of negative life events while maintaining individual emotional stability during adolescent development can effectively reduce the prevalence of NSSI in adolescents.
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Affiliation(s)
- Zhongliang Jiang
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China
| | - Zhiyi Wang
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China
| | - Qidi Diao
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China
| | - Jie Chen
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China
| | - Geng Tian
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China
| | - Xiaojing Cheng
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China
| | - Miao Zhao
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China
| | - Long He
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China
| | - Qiang He
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China
| | - Jin Sun
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong, China
| | - Jintong Liu
- Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China.
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Townsend E, Ness J, Waters K, Rehman M, Kapur N, Clements C, Geulayov G, Bale E, Casey D, Hawton K. Life problems in children and adolescents who self-harm: findings from the multicentre study of self-harm in England. Child Adolesc Ment Health 2022; 27:352-360. [PMID: 35042280 PMCID: PMC9786245 DOI: 10.1111/camh.12544] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Self-harm, a significant and increasing global problem in children and adolescents, is often repeated and is associated with risk of future suicide. To identify potential interventions, we need to understand the life problems faced by children and adolescents, and by sub-groups of younger people who self-harm. Our aims were to include the following: (a) investigate the type and frequency of life problems in a large sample of children and adolescents who self-harmed. (b) Examine whether problems differ between those who repeat self-harm and those who do not. METHODS We analysed data for 2000 to 2013 (follow up until 2014) from the Multicentre Study of Self-harm in England on individuals aged 11 to 18 years who presented to one of the five study hospitals following self-harm and received a psychosocial assessment including questions about problems, which precipitated self-harm. RESULTS In 5648 patients (12,261 self-harm episodes), (75.5% female, mean age 16.1 years) the most frequently reported problems at first episode of self-harm were family problems. Problems around study/employment/study and relationships with friends also featured prominently. The types of problems that precede self-harm differed between late childhood/early adolescence. Abuse, mental health problems and legal problems significantly predicted repeat self-harm for females. CONCLUSION The most common problems reported by both genders were social/interpersonal in nature, indicating the need for relevant services embedded in the community (e.g. in schools/colleges). Self-harm assessment and treatment choices for children and adolescents must take age and gender into account. To prevent future self-harm, individualised supports and services are particularly needed for abuse, mental health and legal problems.
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Affiliation(s)
- Ellen Townsend
- Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK
| | - Jennifer Ness
- Centre for Self-harm and Suicide Prevention Research, Research and Development Centre, Derbyshire Healthcare NHS Foundation Trust, Kingsway Hospital, Derby, UK
| | - Keith Waters
- Centre for Self-harm and Suicide Prevention Research, Research and Development Centre, Derbyshire Healthcare NHS Foundation Trust, Kingsway Hospital, Derby, UK
| | - Muzamal Rehman
- Centre for Self-harm and Suicide Prevention Research, Research and Development Centre, Derbyshire Healthcare NHS Foundation Trust, Kingsway Hospital, Derby, UK
| | - Navneet Kapur
- Centre for Mental Health and Safety, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Caroline Clements
- Centre for Mental Health and Safety, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Galit Geulayov
- Centre for Suicide Research, University Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Elizabeth Bale
- Centre for Suicide Research, University Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Deborah Casey
- Centre for Suicide Research, University Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Keith Hawton
- Centre for Suicide Research, University Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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Wei C, Wang Y, Ma T, Zou Q, Xu Q, Lu H, Li Z, Yu C. Gratitude buffers the effects of stressful life events and deviant peer affiliation on adolescents’ non-suicidal self-injury. Front Psychol 2022; 13:939974. [PMID: 36248536 PMCID: PMC9561820 DOI: 10.3389/fpsyg.2022.939974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Although stressful life events have been shown to be a key risk factor for adolescent NSSI, the potential mediators and moderators of this relationship are unclear. Based on the social development theory and the organism-environment interaction model, we tested whether the link between stressful life events and adolescent NSSI was explained in part by deviant peer affiliation, and whether this process was buffered by gratitude. Chinese adolescents (N = 854; Mage = 16.35; 68.50% female) anonymously completed questionnaires to assess the study variables. The present study demonstrated that stressful life events was linked to NSSI in part because of deviant peer affiliation, and high gratitude was a key protective factor to buffer this indirect effect. Teaching gratitude may be a helpful component of prevention and intervention programs to reduce adolescent NSSI.
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Affiliation(s)
- Chang Wei
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yu Wang
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
- *Correspondence: Yu Wang,
| | - Tao Ma
- Liuxiang Junior High School, Zhuhai, China
| | - Qiang Zou
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
| | - Qian Xu
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
| | - Huixing Lu
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
| | - Zhiyong Li
- College of Education Science, Hubei Normal University, Huangshi, China
| | - Chengfu Yu
- School of Education, Guangzhou University, Guangzhou, China
- Chengfu Yu,
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Yang F, Jiang L, Miao J, Xu X, Ran H, Che Y, Fang D, Wang T, Xiao Y, Lu J. The association between non-suicidal self-injury and negative life events in children and adolescents in underdeveloped regions of south-western China. PeerJ 2022; 10:e12665. [PMID: 35287346 PMCID: PMC8917796 DOI: 10.7717/peerj.12665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/30/2021] [Indexed: 01/07/2023] Open
Abstract
Background The association between negative life events and Non-suicidal self-injury (NSSI) in children and adolescents has been extensively discussed. Nevertheless, little is known about the relationship between negative life events and repetition and severity of NSSI. This survey aims to understand the association between NSSI prevalence, severity, repetition and the negative life events in children and adolescents in underdeveloped regions in south-western China. Methods In this population-based cross-sectional study, 3,146 children and adolescents were included from underdeveloped regions of south-western China, and each of them requested to complete a self-assessment questionnaire. The Modified Version of Adolescents Self-Harm Scale (MASHS) and the Adolescent Self-rating negative Life Events Check-list were used to evaluate NSSI behaviors and negative life events, respectively. The statistical implementation of this study was carried out in the R statistical software, and the logistic regression analysis method was used to analyze the relationship between negative life events and adolescents' non-suicidal self-injury behaviors. Results The average age of all included participants was 13.31 years old. The lifetime prevalence of NSSI was 47.0% (95% CI [36.3-58.0%]). Gender, grade level and ASLEC was positively associated with NSSI. Further analysis revealed that, for all five dimensions of ASLEC, only interpersonal relationship factor (IRF) (OR 1.77 (95% CI [1.06-2.97])), health adaptation factor (HAF) (OR 2.08 (95% CI [1.31-3.31])) showed prominent association with NSSI. Multivariate Logistic regression models revealed that, repetitive NSSI (OR 4.54 (95% CI [3.66-5.63])) and NSSI severity (OR 9.01 (95% CI [6.11-13.29])) were positively associated with ASLEC. Conclusion NSSI is very common among children and adolescents in underdeveloped regions of south-western China. Negative life event are positively associated with NSSI, repeated NSSI, and severe NSSI. Negative life events centered intervention measures might be effective in reducing NSSI among school children and adolescents in underdeveloped regions of south-western China.
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Affiliation(s)
- Fan Yang
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Linling Jiang
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Jing Miao
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Xiufeng Xu
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Hailiang Ran
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Yusan Che
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Die Fang
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - TianLan Wang
- Lincang Psychiatric Hospital, Lincang, Yunnan, China
| | - Yuanyuan Xiao
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Jin Lu
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
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16
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Zheng H, Liu D, Cheng J, Wang DB, Liu Y, Wu Y. Negative life events increase the risk of suicidal ideation in 6653 Chinese freshmen: From a 1-year longitudinal study. J Affect Disord 2022; 299:604-609. [PMID: 34942231 DOI: 10.1016/j.jad.2021.12.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/07/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Suicide is one of the leading causes of juvenile death. Suicidal ideation (SI) is a strong predictor of suicide, while negative life events are associated with SI in adolescents. The aim of this study was to investigate the effect of negative life events on SI in a sample of Chinese freshmen. METHODS The current study employed a cluster sampling method with 7118 freshmen at baseline and 6653 at follow-up. Negative life events were assessed by using the Adolescent Self-Rating Life Events Check List (ASLEC), and SI was assessed by a separate question for self-report. The PHQ-9 was used to measure depression at baseline. RESULTS The incidence of suicidal ideation was 1.52% (95% CI: 1.22%-1.81%). Two dimensions of negative life events, interpersonal relationship and others were risk factors for SI, while female students were more susceptible to them. Consistently, interpersonal relationship and others were risk factors for SI in participants without depression and with mild depression. However, health & adaptation was found to be the only dimension of negative life events contributing to the risk of SI in participants with moderate, severe and extremely severe depression. LIMITATIONS There may be recall bias in this study. CONCLUSIONS Negative life events increase the risk of SI in college students. Female students are more susceptible to negative life events. The effect of different dimensions of negative life events on SI varies in participants with and without depression.
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Affiliation(s)
- Huancheng Zheng
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China
| | - Debiao Liu
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Jing Cheng
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China
| | - Deborah Baofeng Wang
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Yan Liu
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China.
| | - Yili Wu
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, School of Mental Health and The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, Zhejiang 325001, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China.
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Lee JY, Kim H, Kim SY, Kim JM, Shin IS, Kim SW. Non-suicidal self-injury is associated with psychotic like experiences, depression, and bullying in Korean adolescents. Early Interv Psychiatry 2021; 15:1696-1704. [PMID: 33461244 DOI: 10.1111/eip.13115] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 11/28/2022]
Abstract
AIM Non-suicidal self-injury (NSSI) is common among adolescents, and several different factors can affect its prevalence. The present study examined the associated characteristics predicting NSSI among adolescents in South Korea. METHODS In total, 1674 high school students were recruited for a cross-sectional survey. They completed self-reported assessments, including the Deliberate Self-Harm Inventory (DSHI), the Center for Epidemiological Studies Depression Scale (CESD), the State-Trait Anxiety Inventory for Children (STAIC), and the Prodromal Questionnaire-16 (PQ-16), as well as their bullying experience. The NSSI group was defined as the sample group with at least one NSSI behaviour on the DSHI scale. A logistic regression analysis was performed using the NSSI group as the dependent variable. RESULTS The prevalence of NSSI was 28.3% (boys, 30.4%; girls, 24.4%) among adolescents. The most common type of NSSI behaviour among adolescents was interference with wound healing and sex differences in the method were examined. The CES-D, STAIC-trait, and PQ-16 scores were significantly higher and the RSES score was significantly lower in the NSSI group than those in the non-NSSI group. Participants' experience with bullying, such as being victims, bullies, bully-victims, and witness to bullying, were more likely to be in the NSSI group. In a logistic regression analysis, NSSI was significantly associated with male sex, low academic achievement, higher depression, psychotic-like experiences, being bullied, and witnessing bullying. CONCLUSION The results of this study suggest the need to identify and manage related psychologic factors in adolescents with NSSI, including psychotic-like symptoms.
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Affiliation(s)
- Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
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18
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Drubina B, Kökönyei G, Reinhardt M. Associations between non-suicidal self-injury and negative romantic relationship life events in male justice-involved adolescents. BMC Psychiatry 2021; 21:401. [PMID: 34388998 PMCID: PMC8361803 DOI: 10.1186/s12888-021-03408-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/19/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In the current study we investigated impulsivity and negative life events in relation to non-suicidal self-injury (NSSI) in correctional settings. METHODS A total of 141 male justice-involved juveniles participated in our cross-sectional study, aged between 14 and 21 years old (M = 17.75; SD = 1.38). Data collection took place in correctional institutions in Hungary. A binary logistic regression was conducted to investigate possible associations between NSSI, impulsivity and negative life events. RESULTS Lifetime prevalence of NSSI was 53.9% (N = 76). In a binary logistic regression model, only negative romantic relationship events were significantly associated with the risk of current NSSI (OR = 1.29; 95% CI = [1.06-1.56]). Other types of negative life events (family-related, friendship-related), impulsivity, age and conviction status did not have a significant role in the model. CONCLUSIONS The results suggest that juvenile offenders should receive additional support to manage stress that is associated with negative life events, especially problems in romantic relationships. It is essential to help young inmates to find an adaptive way of reducing stress caused by negative relationship life events.
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Affiliation(s)
- Boglárka Drubina
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. .,Department of Clinical Psychology and Addiction, Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest, H-1064, Hungary. .,Child Protection Centre of Budapest and Local Child Protection Professional Services, Expert Committee, Budapest, Hungary.
| | - Gyöngyi Kökönyei
- grid.5591.80000 0001 2294 6276Department of Clinical Psychology and Addiction, Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest, H-1064 Hungary ,grid.11804.3c0000 0001 0942 9821SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary ,grid.11804.3c0000 0001 0942 9821Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Melinda Reinhardt
- Department of Clinical Psychology and Addiction, Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest, H-1064, Hungary. .,XIV District Medical Center, Child and Adolescent Psychiatry, Budapest, Hungary.
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Uncovering the Mystery of Non-Suicidal Self-Injury Among Selected Filipino Adolescents: A Grounded Theory Approach. PSYCHOLOGICAL STUDIES 2021. [DOI: 10.1007/s12646-021-00619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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20
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Baetens I, Greene D, Van Hove L, Van Leeuwen K, Wiersema JR, Desoete A, Roelants M. Predictors and consequences of non-suicidal self-injury in relation to life, peer, and school factors. J Adolesc 2021; 90:100-108. [PMID: 34182197 DOI: 10.1016/j.adolescence.2021.06.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Numerous life, peer, and school-related factors have been found to be associated with non-suicidal self-injury (NSSI) among adolescents; however, most studies have not explored the possible reciprocal nature of these associations. The aim of the current study was to examine bidirectional and longitudinal associations between NSSI and several life, peer, and school-related factors (i.e., stressful life events, peer relationships, academic achievement, and attitudes towards school). METHOD Community-based adolescents completed questionnaires assessing the variables of interest at three time points; age 12 (T1; 55.09% girls), age 13 (T2; 56.95% girls), and ages 14-15 (T3; 57.41% girls). In total, 529 adolescents provided complete data across all three-time points. RESULTS Analyses showed a bidirectional association between NSSI and both attitudes towards school and stressful life events. Specifically, stressful life events at T2 predicted engagement in NSSI at T3, and NSSI at T2 predicted increased risk of stressful life events at T3. Similarly, having negative attitudes towards school predicted NSSI at T2, which, in turn, predicted negative attitudes towards school at T3. Further, academic achievement at T1 was negatively associated with NSSI at T2. Peer relationships were neither a predictor nor a consequence of NSSI. CONCLUSIONS Our results suggest that NSSI can be both a predictor and a consequence of various life, and school factors. Focus on these factors in prevention and intervention efforts for NSSI among adolescents may be warranted.
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Affiliation(s)
- I Baetens
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
| | - D Greene
- School of Psychology, Curtin University, Australia
| | - L Van Hove
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - K Van Leeuwen
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - J R Wiersema
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - A Desoete
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - M Roelants
- Department of Public Health and Primary Care, KU Leuven, Belgium
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21
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Du N, Ouyang Y, Xiao Y, Li Y. Psychosocial Factors Associated With Increased Adolescent Non-suicidal Self-Injury During the COVID-19 Pandemic. Front Psychiatry 2021; 12:743526. [PMID: 34955911 PMCID: PMC8703160 DOI: 10.3389/fpsyt.2021.743526] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Non-suicidal self-injury (NSSI) in adolescents hospitalized with psychiatric disorders continues to increase after the outbreak of COVID-19. This study aimed to explore the relationship between the pandemic and NSSI among adolescents and whether the composition of psychosocial factors related to NSSI has changed during the pandemic. Through the retrospective analysis of medical records retrieved from the electronic system of the psychiatric hospital located in Chengdu from January 2016 to March 2021, 609 medical records of adolescents were obtained. The main potential psychosocial factors were determined by deductive content analysis. Among the 609 adolescents, 420 subjects had engaged in NSSI, while 189 did not. We found that the percentage of adolescents who had engaged in NSSI in 2016 was only 29.2%, reaching 34.5% in 2017, 45.7% in 2018, 61.3% in 2019, 92.5% in 2020, and 95.9% in 2021. In the binary logistic regression model, female sex (OR = 0.073, 95% CI: 0.028-0.186), older age (OR = 1.234, 95% CI: 1.030-1.478), having a single parent (OR = 7.865, 95% CI: 3.997-15.476), having experienced trauma (OR = 2.192, 95% CI: 1.032-4.654), having experienced social isolation from peers (OR = 8.139, 95% CI: 4.037-16.408), having experienced body-focused bullying (OR = 3.078, 95% CI: 1.295-7.318), overuse of a mobile phone in the parents' opinions (OR = 4.354, 95% CI: 1.380-13.738), having attempted suicide (OR = 9.120, 95% CI: 4.492-18.512), and during the pandemic (time point is January 30, 2020) (OR = 5.399, 95% CI: 1.679-17.357) were the factors that were significantly associated with NSSI. When comparing the differences in psychosocial factors between the pre-pandemic and the during-pandemic groups, the results showed that the family constitution, parent-child relationships, mobile phone overuse, and stressful learning were important factors. Tailored interventions geared towards changed psychosocial factors should be formulated.
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Affiliation(s)
- Na Du
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Yingjie Ouyang
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Yu Xiao
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Yunge Li
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China
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22
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The Correlation between Oral Self-Harm and Ethnicity in Institutionalized Children. CHILDREN-BASEL 2020; 8:children8010002. [PMID: 33374663 PMCID: PMC7822475 DOI: 10.3390/children8010002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 12/03/2022]
Abstract
Oral self-harm was described in institutionalized children who share a lack of emotional attention; frequently these children experience feelings such as neglect, loneliness, isolation or lack of connection with the world. The aim of our paper was to conduct a cross-sectional study in order to assess the prevalence of this behavior and its correlation with ethnicity among children from three institutions located in the central part of Romania. We examined 116 children from three ethnic groups, Romanians, Hungarians and local Roma population aged between 10–14 years old. The oral soft tissues were evaluated by one dentist who recorded the lesions of lips, buccal mucosa, commissures and tongue; data were statistically analyzed at a level of significance of p < 0.05. We found oral self-harm lesions in 18.1% participants, with statistically significant higher odds in girls (p = 0.03). The results showed an association between ethnicity and the development of these lesions (Chi-square p = 0.04). The most frequent lesions were located at oral commissures (35.48%), buccal mucosa (29.03%) and upper lip (19.36%). Oral self-harm lesions have a high incidence among institutionalized children in Romania. Identification of these cases in early stages is important, as these conditions are known to be aggravated during adolescence and adulthood.
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23
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Dunlop BJ, Hartley S, Oladokun O, Taylor PJ. Bisexuality and Non-Suicidal Self-Injury (NSSI): A narrative synthesis of associated variables and a meta-analysis of risk. J Affect Disord 2020; 276:1159-1172. [PMID: 32823255 DOI: 10.1016/j.jad.2020.07.103] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/18/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Bisexual people have been found to be at increased risk of non-suicidal self-injury (NSSI) when compared to heterosexual and gay or lesbian people. The purpose of this review was to update the estimated risk of NSSI for bisexual people and to examine variables that have been associated with NSSI in this population. METHODS The protocol for this paper was pre-registered (CRD42019145299). An electronic search of PsycINFO, CINAHL Plus, PubMed, Ovid Online and Web of Science was undertaken from earliest available date to October 2019. Twenty-four eligible papers were identified. Meta-analyses, including moderator analysis, were conducted to ascertain NSSI risk and a narrative synthesis was undertaken of predictors and correlates. All studies were assessed for risk of bias. RESULTS Bisexual people had up to six times the odds of engaging in NSSI compared to other sexualities. Mental health variables of anxiety and depression symptoms were found to be most commonly associated with NSSI for this population. The majority of studies had moderate risk of bias. This review demonstrates that bisexual people have an elevated risk of engaging in NSSI. Increased incidence of anxiety and depression and exposure to negative life events may explain this increased risk. LIMITATIONS Studies were found to be consistently cross-sectional in design and limited to western cultures. A limitation of this review was that only English language papers were included. CONCLUSIONS Results are clinically relevant as they suggest early identification and prevention of NSSI can be achieved. Future research should examine bisexual people independently of others.
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Affiliation(s)
- Brendan J Dunlop
- Division of Psychology and Mental Health, The University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, United Kingdom.
| | - Samantha Hartley
- Division of Psychology and Mental Health, The University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, United Kingdom
| | - Olayinka Oladokun
- Division of Psychology and Mental Health, The University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, United Kingdom
| | - Peter J Taylor
- Division of Psychology and Mental Health, The University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, United Kingdom
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24
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Sailly S, Khanande RV, Munda SK, Mehta VS. Body-focused repetitive behaviors in school-going children and adolescents and its relationship with state-trait anxiety and life events. Indian J Psychiatry 2020; 62:703-706. [PMID: 33896977 PMCID: PMC8052876 DOI: 10.4103/psychiatry.indianjpsychiatry_607_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/25/2019] [Accepted: 10/01/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Body-focused repetitive behaviors (BFRBs) are nonfunctional self-injurious behaviors. BFRBs fall under obsessive-compulsive and related disorders (OCRDs) and co-occur with anxiety disorders. AIM The current study plans to assess the presence of BFRBs in schoolchildren and adolescents and find its relationship with state-trait anxiety and significant life events. MATERIALS AND METHODS The study identified twenty-one students with BFRBs using the Modified Habit Questionnaire. Along with the 21 matched healthy controls, both the groups were evaluated on the State-Trait Anxiety Inventory for Children (STAIC) and Life Event Scale for Indian Children (LESIC). RESULTS The study group scored significantly high on STAIC state score (P = 0.004), trait score (P = 0.014), and total score (P = 0.020). On five life events, the study group reported significantly high on stress. CONCLUSION The study reports the presence of BFRBs in schoolchildren; state-trait anxiety and significant life events have a significant association with BFRBs.
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Affiliation(s)
- Swati Sailly
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | | | - Sanjay Kumar Munda
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
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Tang J, Ma Y, Lewis SP, Chen R, Clifford A, Ammerman BA, Gazimbi MM, Byrne A, Wu Y, Lu X, Chang H, Kang C, Tiemeier H, Yu Y. Association of Internet Addiction With Nonsuicidal Self-injury Among Adolescents in China. JAMA Netw Open 2020; 3:e206863. [PMID: 32496567 PMCID: PMC7273191 DOI: 10.1001/jamanetworkopen.2020.6863] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE Both nonsuicidal self-injury (NSSI), defined as the direct, deliberate damage of one's body tissue without suicidal intent, and internet addiction among adolescents are public health concerns. However, the possible association of NSSI with internet addiction is not well understood. OBJECTIVE To examine the occurrence of internet addiction with NSSI and any sex differences among Chinese adolescents. DESIGN, SETTING, AND PARTICIPANTS A multicenter, cross-sectional, survey study was conducted from February 18 to October 15, 2015, among adolescents aged 11 to 20 years from 343 classes in 45 public high schools across 5 provinces of China. Data analysis was performed from August 1, 2018, to March 1, 2019. EXPOSURES Possible internet addiction and internet addiction. MAIN OUTCOMES AND MEASURES Less-frequent (1-4 times) NSSI and more-frequent (≥5 times) NSSI were surveyed using the Chinese version of the Functional Assessment of Self-Mutilation. RESULTS A total of 15 623 students (8043 male [51.5%] and 7580 female [48.5%]) aged 11 to 20 years (mean [SD] age, 15.1 [1.8] years) participated. Of these, 4670 participants (29.9%) met the criteria for possible internet addiction and 509 participants (3.3%) met the criteria for internet addiction. A total of 2667 students (17.1%) engaged in less-frequent NSSI, while 1798 students (11.5%) engaged in more-frequent NSSI in the 12 months preceding the survey. Both possible internet addiction and internet addiction were associated with less-frequent or more-frequent NSSI. The adjusted odds ratios were 1.29 (95% CI, 1.17-1.42) for possible internet addiction and 1.41 (95% CI, 1.11-1.80) for internet addiction for less-frequent NSSI; for more-frequent NSSI, the adjusted odds ratios were 1.75 (95% CI, 1.56-1.96) for possible internet addiction and 2.66 (95% CI, 2.10-3.38) for internet addiction. These associations were similarly observed among age groups of 11 to 14, 15 to 17, and 18 to 20 years. No sex disparities were found in the associations of internet addiction with NSSI, except among adolescents aged 11 to 14 years, where the odds ratios for possible internet addiction with less-frequent NSSI were higher in male adolescents (1.53; 95% CI, 1.25-1.88) than female adolescents (1.13; 95% CI, 0.90-1.47). CONCLUSION AND RELEVANCE Internet addiction appears to be associated with NSSI, and the findings of this study suggest that the association was similar between male adolescents and female adolescents. These data suggest that evaluation of the risk of NSSI for adolescents in association with internet addiction may help health care professionals in developing preventive interventions for NSSI.
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Affiliation(s)
- Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou, P. R. China
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Ying Ma
- Department of Child Healthcare, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, P. R. China
| | - Stephen P. Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Angela Clifford
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | | | - Marufu Martin Gazimbi
- Global Development Institute, ALB, University of Manchester, Manchester, United Kingdom
| | - Adrian Byrne
- School of Medicine, Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Yu Wu
- Shenzhen Center for Disease Control and Prevention, Nanshan District, Shenzhen, P. R. China
| | - Xinchuan Lu
- Department of Child and Adolescent Psychiatry, Suzhou Guangji Hospital, Suzhou, P. R. China
| | - Hongjuan Chang
- Department of Maternal and Child Healthcare, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, P. R. China
| | - Chun Kang
- Department of Maternal and Child Healthcare, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, P. R. China
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Centre–Sophia Children's Hospital, Rotterdam, the Netherlands
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Yizhen Yu
- Department of Maternal and Child Healthcare, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hankou District, Wuhan, P. R. China
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26
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Zhang F, Cloutier PF, Yang H, Liu W, Cheng W, Xiao Z. Non-suicidal self-injury in Shanghai inner bound middle school students. Gen Psychiatr 2019; 32:e100083. [PMID: 31552387 PMCID: PMC6738666 DOI: 10.1136/gpsych-2019-100083] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/28/2019] [Accepted: 07/19/2019] [Indexed: 12/18/2022] Open
Abstract
Background Non-suicidal self-injury (NSSI) behaviour is very common among adolescents. Its prevalence and behavioural characteristics may vary according to regional and cultural differences. Investigation of NSSI locations and diagnosis of adolescents with NSSI are relatively lacking in China. Aims The study objective was to determine the prevalence and features of NSSI among middle school students in Shanghai. Methods The participants were from grade 6 to 8 selected from three junior schools in Jing’an District. Consenting students completed the Ottawa Self-Injury Inventory to determine the prevalence and characteristics of NSSI. Those who indicated NSSI within the past month were administered the Mini-International Neuropsychiatric Interview for Children and Adolescents to assess for emotional disorders. Result The result shows 510 participants (21.7%; mean age 13.51 (0.97) years old; 56.7% female) reported at least one instance of NSSI during the previous 12 months. NSSI was significantly more common in girls than boys (24.9% vs 18.5%; χ2=14.03, p=0.00). Commonly reported reasons for NSSI were for internal and external emotion regulation (87.9%, 82.3%) and social influence (57.8%). Anxiety disorders were the most common (28.9%) disorder associated with NSSI. Conclusion The rate of NSSI of middle school students in Shanghai inner bound is similar to those reported in North American and European youth. It is essential that school mental health professionals are aware of how to manage NSSI within the school setting.
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Affiliation(s)
- Fang Zhang
- Department of Medical psychology, Shanghai General hospital, Medical School of Shang Hai Jiaotong University, Shanghai, China
| | | | - Hongmei Yang
- Shanghai Jing'an Education College, Shanghai, China
| | - Wenjing Liu
- Shanghai Mental Health Center, Medical School of Shang Hai Jiaotong University, Shanghai, China
| | - Wenhong Cheng
- Department of Medical psychology, Shanghai General hospital, Medical School of Shang Hai Jiaotong University, Shanghai, China.,Shanghai Mental Health Center, Medical School of Shang Hai Jiaotong University, Shanghai, China
| | - Zeping Xiao
- Shanghai Mental Health Center, Medical School of Shang Hai Jiaotong University, Shanghai, China
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27
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Wang Q, Liu X. Peer victimization, depressive symptoms and non-suicidal self-injury behavior in Chinese migrant children: the roles of gender and stressful life events. Psychol Res Behav Manag 2019; 12:661-673. [PMID: 31496850 PMCID: PMC6698170 DOI: 10.2147/prbm.s215246] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/23/2019] [Indexed: 12/23/2022] Open
Abstract
Background Non-suicidal self-injury (NSSI) has become a worldwide health concern, especially for the disadvantaged group such as Chinese rural-to-urban migrant children. Peer victimization is a risk factor for NSSI and is quite common among Chinese migrant children. However, few studies that focused on this group have paid attention to the relationship between peer victimization and NSSI. The current study addressed this gap in the literature by examining the mediating role of depressive symptoms and the moderating role of stressful life events in the relationship between peer victimization and NSSI in male and female migrant children. Methods A total of 650 migrant children completed self-report surveys that addressed peer victimization, NSSI, depressive symptoms, and stressful life events. Results Results showed that peer victimization was significantly related to NSSI for both migrant girls and boys. Depressive symptoms mediated the relationship between peer victimization and NSSI among girls, but not among boys. Additionally, stressful life events significantly moderated the relationships between depressive symptoms and NSSI and between peer victimization and NSSI among girls; higher levels of depressive symptoms or peer victimization coupled with more stressful life events related to a higher probability of NSSI. For boys, stressful life events moderated the relationship between peer victimization and NSSI; higher levels of peer victimization combined with increased NSSI behaviors among the boys who reported more stressful life events. Conclusions These findings contribute to the understanding of the mechanisms that inform the relationship between peer victimization and NSSI. Moreover, they indicate that future interventions can be enhanced by targeting depressive symptoms among girls and stressful life events among both girls and boys.
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Affiliation(s)
- Quanquan Wang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, People's Republic of China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, People's Republic of China
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28
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Lan T, Jia X, Lin D, Liu X. Stressful Life Events, Depression, and Non-Suicidal Self-Injury Among Chinese Left-Behind Children: Moderating Effects of Self-Esteem. Front Psychiatry 2019; 10:244. [PMID: 31057441 PMCID: PMC6478804 DOI: 10.3389/fpsyt.2019.00244] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 04/01/2019] [Indexed: 12/03/2022] Open
Abstract
Using cross-sectional data of the children in the Guizhou Province of China, the present study examined the association between stressful life events and self-esteem, depression, and non-suicidal self-injury (NSSI). The participants included 1,210 children recruited from four junior high schools. Self-report questionnaires concerned stressful life events, self-esteem, depression, and NSSI. Results indicated that Chinese left-behind children who faced more stressful life events were more likely to engage in depression and non-suicidal self-injury (NSSI). Moreover, self-esteem moderated the association between stressful life events and depression, and the association between stressful life events and NSSI. For the left-behind children reporting higher levels of self-esteem, the negative effect of stressful life events on depression and NSSI appeared weaker, compared to those who reported lower levels of self-esteem. In addition, the left-behind type also has a moderating effect on the relationship between stressful life events and NSSI. With the increase of stressful life events, the NSSI among the one-migrating-parent group grows more rapidly than that among the two-migrating-parents group. The findings suggest that self-esteem and left-behind type are important individual factors for Chinese left-behind children.
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Affiliation(s)
- Tian Lan
- Beijing Normal University, Beijing, China
| | - Xuji Jia
- Tianjin Normal University, Tianjin, China
| | - Danhua Lin
- Beijing Normal University, Beijing, China
| | - Xia Liu
- Beijing Normal University, Beijing, China
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29
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Abstract
Recent studies have revealed a high rate of nonsuicidal self-injury (NSSI) behavior in Chinese students, but quantitative syntheses of pooled prevalence are sparse. There have been several NSSI prevalence meta-analyses in other populations. However, given the existence of cultural diversity, racial difference, educational system difference and so on, these results may not be ideal for Chinese populations. Furthermore, the above-mentioned meta-analyses did not include Chinese database which may have led to unintentional bias. Thus, we conducted this meta-analysis to estimate the prevalence of NSSI in Chinese middle-school students.The databases searched included PubMed, Embase, Web of Science, CBM (Chinese database), Chinese National Knowledge Infrastructure (CNKI), Wanfang Data (Chinese database) and the Weipu database (Chinese database). The search terms included: self-injury/self-harm/self-abuse/nonsuicidal self-injury/deliberate self-harm, adolescen*/youth/teen/students, and China/Chinese. All relevant articles published between January 2000 to November 2017, in either Chinese or English, were included. Two investigators were engaged in this process, and any disagreements were settled by a third investigator. A random effects model was then used to calculate the pooled prevalence.A total of 420 studies with 160,348 participants were retrieved. The pooled prevalence was 22.37% (95% CI: 18.84%-25.70%). Substantial heterogeneity in prevalence estimates was revealed. Subgroup analyses showed that the pooled estimate of prevalence of life time NSSI was 14.5% (95%CI: 0.06%-22.7%), and 6-24 months NSSI was23.3% (95%CI: 20.5%-26.1%). The prevalence for males was 20.6% (95% CI: 16.1%-25.0%), and for females was 21.9% (95% CI: 17.6%-26.2%).The prevalence of NSSI in Chinese middle-school students is relatively high. More attention should be paid to the current situation.
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30
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Liu W, Sun H, Zhang X, Chen Q, Xu Y, Chen X, Ding Z. Air pollution associated with non-suicidal self-injury in Chinese adolescent students: A cross-sectional study. CHEMOSPHERE 2018; 209:944-949. [PMID: 30114744 PMCID: PMC6100799 DOI: 10.1016/j.chemosphere.2018.06.168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/12/2018] [Accepted: 06/27/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a frequent phenomenon in adolescents and is closely related to eventual suicide. Although the effect of air pollution on various diseases has been extensively investigated, no studies examined its effect on NSSI in young students. OBJECTIVES We investigated the effect of air pollution on NSSI in Chinese students. METHODS We investigated the incidence of NSSI in the past 12 months in 54 923 Chinese students with an anonymous questionnaire. We assessed the air pollution exposure of each student by the air quality matched with their schools, which were calculated by the inverse distance weighting method from the environmental monitoring data. We discussed the association between ambient air pollutants and the incidence of NSSI using generalized additive mixed models. RESULTS A 10 μg/m3 increase in the annual moving average concentration of particulate matter with diameters less than 2.5 μm (PM2.5) and ozone (O3) was associated with a 13.9 percent and a 10.5 percent increase in the odds ratio (OR) of NSSI, respectively. In addition, a 0.1 mg/m3 increase in the annual moving average concentration of carbon monoxide (CO) was associated with a 4.8 percent increase in the OR of NSSI. NO2 and SO2 were not related to NSSI. CO and O3 show non-linear effects on NSSI. Male students in high school are the most s to the effects of PM2.5 on NSSI. CONCLUSIONS Our study suggests that increases in PM2.5, O3 and CO may increase the incidence of NSSI among adolescent students.
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Affiliation(s)
- Weina Liu
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China
| | - Hong Sun
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China.
| | - Xin Zhang
- School of Statistics, Beijing Normal University, 19 XinJieKouWai Street, 100875 Beijing, China
| | - Qi Chen
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China
| | - Yan Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China
| | - Xi Chen
- Department of Health Policy and Management, Department of Economics, Yale University, 60 College St., New Haven, CT 06520, USA
| | - Zhen Ding
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, China.
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31
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Midkiff MF, Lindsey CR, Meadows EA. The role of coping self-efficacy in emotion regulation and frequency of NSSI in young adult college students. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1520437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Melanie F. Midkiff
- Department of Psychology, Northwestern State University of Louisiana, Natchitoches, LA, USA
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Cynthia R. Lindsey
- Department of Psychology, Northwestern State University of Louisiana, Natchitoches, LA, USA
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Cerutti R, Zuffianò A, Spensieri V. The Role of Difficulty in Identifying and Describing Feelings in Non-Suicidal Self-Injury Behavior (NSSI): Associations With Perceived Attachment Quality, Stressful Life Events, and Suicidal Ideation. Front Psychol 2018; 9:318. [PMID: 29593617 PMCID: PMC5859383 DOI: 10.3389/fpsyg.2018.00318] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/26/2018] [Indexed: 11/16/2022] Open
Abstract
Objective: Core alexithymic features, such as the difficulty in identifying and describing feelings, are associated with poor attachment styles and emotional trauma, which influence the capacity to regulate affect. Additionally, emotional regulation has been found to be the most commonly identified function associated with non-suicidal self-injury behavior (NSSI) in adolescents as they attempt to modulate strong emotions. However, few studies have examined the link between difficulty in identifying and describing feelings (core components of alexithymia), NSSI behaviors, quality of attachment, life stressors and suicidal ideation in healthy early adolescents. Consequently, this study aims to investigate these constructs and the relationship among them in a large non-clinical sample of adolescents. Methods: Seven hundred and nine middle school students (50.4% males), aged 10–15 years (M = 12.6; SD = 1.06) were involved in this study. In order to investigate the variables considered in the study, the following measures were administered: the Deliberate Self-Harm Inventory exploring non-suicidal self-injurious behaviors; the Alexithymia Questionnaire for Children examining difficulty in identifying and describing feelings; the Inventory of Parent and Peer Attachment assessing the quality of parental and peer attachment; the Life Stressor Checklist-Revised outlining stressful/traumatic events and the Children’s Depression Inventory evaluating suicidal ideation. Results: We found significantly positive relationships among difficulty in identifying and describing feelings, NSSI behaviors, stressful events, and suicidal ideation. Data indicated a significant negative association of difficulty in identifying and describing feelings with quality of attachment to parents and peers. Further findings highlighted that difficulty in identifying and describing feelings significantly mediated the effect of quality of attachment (parent and peer) on NSSI and suicidal ideation. Conclusion: The ability to identify and describing feelings is important to managing emotional expression and understanding the feelings of others, both crucial in attaining successful interpersonal relationships. Our data revealed that, while controlling for stressful life events, low levels of attachment may increase adolescents’ difficulty in identifying and describing their own feelings, which in turn may increase the risk of both NSSI and suicidal ideation.
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Affiliation(s)
- Rita Cerutti
- Department of Dynamic and Clinic Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonio Zuffianò
- Department of Psychology, Liverpool Hope University, Liverpool, United Kingdom
| | - Valentina Spensieri
- Department of Dynamic and Clinic Psychology, Sapienza University of Rome, Rome, Italy
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Tang J, Li G, Chen B, Huang Z, Zhang Y, Chang H, Wu C, Ma X, Wang J, Yu Y. Prevalence of and risk factors for non-suicidal self-injury in rural China: Results from a nationwide survey in China. J Affect Disord 2018; 226:188-195. [PMID: 28988001 DOI: 10.1016/j.jad.2017.09.051] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 09/07/2017] [Accepted: 09/22/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a highly prevalent and serious public health problem among adolescents worldwide. However, to date there were no studies assessing the prevalence of NSSI defined by suggested DSM-5 criteria among Chinese adolescents. We aimed to conduct a nationwide survey to explore the prevalence of and risk factors for NSSI among school-based adolescents in rural China. METHODS A total sample of 15,623 adolescents in rural China were enrolled by using a multistage sampling method. Data was collected by self-report questionnaires including demographic characteristics, neglect, maltreatment, loneliness, resilience, social support and emotional management ability. NSSI was defined by suggested DSM-5 criteria, according to which the engagement in self-injury took place more than 5 times a year. Multinomial logistic regression models were used to estimate the association between risk factors and NSSI. RESULTS There were 12.2% of adolescents (n = 1908) met the suggested DSM-5 criteria. Approximately 29% reported a history of NSSI at least once during the last year. Significant differences were found in several demographic factors including gender, ethnicity, grade, and family structure between adolescents with and without experiencing NSSI. The top three NSSI behaviors among adolescents with NSSI experience were hitting self, pinching, and pulling hair, with a prevalence rate of 16.7%, 14.1% and 11.2%, respectively. Female, Han ethnicity, fathers' education level, neglect, maltreatment, loneliness, social support, suicidal behaviors and emotional management ability were significantly associated with NSSI by multivariate analysis. No significant relationship was found between resilience and risk of NSSI. LIMITATION The DSM-5 has proposed 6 groups of criteria for NSSI, we only used criteria on frequency given its more accepted feasibility and pragmatic application. Consequently, it may different from other prevalence that estimated by other criteria. CONCLUSION To the best of our knowledge, this is the first study reporting prevalence of NSSI defined by suggested DSM-5 criteria among adolescent in rural China. In comparison to finding from the similar samples of adolescents, Chinese rural adolescents seem to have a relative higher prevalence. The potential risk factors for NSSI include female, father's education, Han ethnicity, psychosocial factors and suicide behaviors. More evidence for further understanding of context of the occurrence, improving access to health care utilization, and identifying the role of psychosocial factors and family relationship, is needed for the prevention and management of NSSI.
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Affiliation(s)
- Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Guowei Li
- Department of Clinical Epidemiology & Biostatistics, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON L8S 4L8, United States.
| | - Baoxin Chen
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
| | - Zhijie Huang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
| | - Yanmei Zhang
- Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China.
| | - Hongjuan Chang
- Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China.
| | - Chunxia Wu
- Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China.
| | - Xiaoguang Ma
- Department of Nutrition and Food Hygiene, Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Jiaji Wang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
| | - Yizhen Yu
- Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China.
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Cipriano A, Cella S, Cotrufo P. Nonsuicidal Self-injury: A Systematic Review. Front Psychol 2017; 8:1946. [PMID: 29167651 PMCID: PMC5682335 DOI: 10.3389/fpsyg.2017.01946] [Citation(s) in RCA: 239] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 10/23/2017] [Indexed: 01/22/2023] Open
Abstract
Objective: Nonsuicidal self-injury (NSSI) refers to the intentional self-inflicted destruction of body tissue without suicidal intention and for purposes not socially sanctioned. Our paper presents an up-to-date overview on nonsuicidal, self-injurious behaviors. Method: In accordance with PRISMA guidelines, a systematic literature search was conducted across two databases, PubMed and PsycARTICLES, regarding the main features of NSSI with a focus on epidemiological and etiologic data, diagnostic criteria, and functions. All English articles, published between 1998 and 2016, were considered, and screened against a priori inclusion/exclusion criteria. The search terms include: self-harm, self-injury, NSSI, epidemiology, comorbidity, gender, functions and DSM. We also examined the references of the retrieved articles. Results: NSSI is most common among adolescents and young adults, and the age of onset is reported to occur between 12 and 14 years. Comorbidity with borderline personality disorder (BPD) and eating disorders is often reported. DSM-5 includes NSSI as a condition requiring further study. This review gives an overview of the prevalence rates (7.5–46.5% adolescents, 38.9% university students, 4–23% adults) and main causes that appear to stem from childhood trauma, comorbidity with many other disorders and several functions of NSSI, and the potential independence of a NSSI disorder. Conclusion: Over the years, interest in NSSI grew to such an extent that an ongoing debate was instigated on whether NSSI should be considered as a diagnosis in its own right and given its own category. This paper provides an up-to-date overview on self-injury, what is known about it and what remains to be done. Clearly, our understanding of the main issues of NSSI has increased in last two decades. However, future researches is needed to examine the developmental trajectories, cultural backgrounds and shed light on the risk factors and functions as well as clarify its role as an independent diagnostic entity.
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Affiliation(s)
- Annarosa Cipriano
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Paolo Cotrufo
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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Lin MP, You J, Ren Y, Wu JYW, Hu WH, Yen CF, Zhang X. Prevalence of nonsuicidal self-injury and its risk and protective factors among adolescents in Taiwan. Psychiatry Res 2017; 255:119-127. [PMID: 28544943 DOI: 10.1016/j.psychres.2017.05.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 03/27/2017] [Accepted: 05/15/2017] [Indexed: 11/18/2022]
Abstract
The present study aimed to investigate the prevalence of nonsuicidal self-injury (NSSI) in a large representative sample of secondary school students and identified the psychosocial risk and protective factors. Using a cross-sectional design, 2170 participants were recruited from senior high schools throughout Taiwan using both stratified and cluster sampling. The one-year prevalence of NSSI was found to be 20.1%. Results suggested that compared to non-injurers, episodic self-injurers reported higher levels of neuroticism and openness, while repetitive self-injurers reported higher levels of neuroticism, openness, avoidance/emotion-focused coping, and virtual social support, and lower levels of self-esteem and cognitive reconstruction/problem-focused coping. Compared to episodic self-injurers, repetitive self-injurers reported a higher level of avoidance/ emotion-focused coping. Additionally, compared to non-injurers, mild self-injurers reported higher levels of neuroticism and openness, while severe self-injurers reported higher levels of neuroticism, openness, avoidance/emotion-focused coping, and virtual social support, and lower levels of self-esteem and cognitive reconstruction/problem-focused coping. Our study found that NSSI is fairly prevalent among secondary school students in Taiwan. Psychosocial risk factors, especially maladaptive coping strategies, should be given special attention when examining adolescents with NSSI. Regarding protective factors, enhancing self-esteem should be the focus of formulating effective intervention strategies for NSSI.
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Affiliation(s)
- Min-Pei Lin
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Section 1, Heping E. Rd., Da-an District, Taipei City 106, Taiwan.
| | - Jianing You
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, and School of Psychology, South China Normal University, No. 155 Zhongshan W. Rd, Tianhe District, Guangzhou, China
| | - Yaxuan Ren
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, and School of Psychology, South China Normal University, No. 155 Zhongshan W. Rd, Tianhe District, Guangzhou, China
| | - Jo Yung-Wei Wu
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan 701, Taiwan
| | - Wei-Hsuan Hu
- Department of Counseling and Guidance, National University of Tainan, No.33, Section 2, Shu-Lin St., Tainan 700, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung 807, Taiwan; Department of Psychiatry, Tainan Municipal Hospital, No.670, Chongde Road, East District, Tainan 701, Taiwan
| | - Xu Zhang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, and School of Psychology, South China Normal University, No. 155 Zhongshan W. Rd, Tianhe District, Guangzhou, China
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The association between life events and internet addiction among Chinese vocational school students: The mediating role of depression. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2016.12.057] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Zhang SC, Tao FB, Wu XY, Tao SM, Fang J. Low health literacy and psychological symptoms potentially increase the risks of non-suicidal self-injury in Chinese middle school students. BMC Psychiatry 2016; 16:327. [PMID: 27650034 PMCID: PMC5028961 DOI: 10.1186/s12888-016-1035-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 09/09/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Low health literacy (HL) has been known to be involved in various risk behaviors and mental disorder among adolescent. The purpose of this study was to examine the independent and interactive association between HL and self-reported mental health with non-suicidal self-injury (NSSI) in Chinese middle school students. METHODS Twenty five thousand three hundred seventy-eight junior and high school students in China were enrolled in this study. The outcomes were self-reported HL, psychological symptoms and NSSI. Logistic regression models were conducted to examine relations between them. RESULTS The prevalence of NSSI was 27.5 %. Low HL was significantly associated with NSSI (OR = 2.538, 95 % CI: 2.335-2.758). Psychological symptoms were significantly positively correlated with NSSI (OR = 3.872, 95 % CI: 3.637-4.123). Low HL and psychological symptoms were independently and interactively associated with increased risks of NSSI. CONCLUSIONS These results suggest that Chinese middle school students with low HL and psychological symptoms are intending to exhibit NSSI. The intervention programs of mental health and behavior problems should enhance HL levels and attenuate the severity of psychological symptoms.
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Affiliation(s)
- Shi-chen Zhang
- Department of Maternal and Child Health, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032 Hefei, Anhui Province People’s Republic of China ,Anhui Provincial Key Laboratory of Population Health & Aristogenics, 81th Meishan Road, 230032 Hefei, Anhui Province People’s Republic of China
| | - Fang-biao Tao
- Department of Maternal and Child Health, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032 Hefei, Anhui Province People’s Republic of China ,Anhui Provincial Key Laboratory of Population Health & Aristogenics, 81th Meishan Road, 230032 Hefei, Anhui Province People’s Republic of China
| | - Xiao-yan Wu
- Department of Maternal and Child Health, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032 Hefei, Anhui Province People’s Republic of China ,Anhui Provincial Key Laboratory of Population Health & Aristogenics, 81th Meishan Road, 230032 Hefei, Anhui Province People’s Republic of China
| | - Shu-man Tao
- Department of Maternal and Child Health, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032 Hefei, Anhui Province People’s Republic of China
| | - Jun Fang
- Department of Toxicology, School of Public Health, Anhui Medical University, 81th Meishan Road, 230032, Hefei, Anhui Province, People's Republic of China. .,Anhui Provincial Key Laboratory of Population Health & Aristogenics, 81th Meishan Road, 230032, Hefei, Anhui Province, People's Republic of China. .,Faculty of Pharmaceutical Science, Sojo University, Ikeda 4-22-1, Kumamoto, 860-0082, Japan.
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