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Wei Q, Liu J, Yin W, Pan S, Dai C, Zhou L, Jiang X, Wang C, Wu J. Association between childhood emotional abuse and non-suicidal self-injury among Guangxi adolescents in China: A moderated mediation model. J Affect Disord 2024; 363:436-444. [PMID: 39029701 DOI: 10.1016/j.jad.2024.07.111] [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: 01/29/2024] [Revised: 06/25/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Childhood Emotional Abuse (CEA) is a known risk factor for Non Suicidal Self-injury (NSSI), which could have devastating repercussions. This study aimed to establish whether Parent-Child Attachment (PCA) and depressive symptoms mediated the CEA-NSSI relationship, as well as whether school connectedness moderated both the direct and indirect relationships between CEA and NSSI. METHODS Between November and December 2022, 7447 Chinese adolescents in high schools were surveyed through multi-stage cluster random sampling. The participants completed self-reported questionnaires that assessed CEA, PCA, depressive symptoms, school connectedness, and NSSI. Relationships between these variables were examined through moderated mediation analysis using SPSS macro-PROCESS. RESULTS After controlling for sociodemographic variables, we found that CEA correlated positively with NSSI through two different pathways: the mediating role of depressive symptoms and the chain-mediating role of both PCA and depressive symptoms. Moreover, school connectedness could moderate the direct and indirect relationships between CEA and NSSI. LIMITATIONS The study's cross-sectional design does not allow for causal inferences. CONCLUSIONS Overall, PCA, depressive symptoms, and school connectedness could affect the CEA-NSSI relationship.
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Affiliation(s)
- Qiaoyue Wei
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan 430071, China; Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Jianbo Liu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, School of mental health, Shenzhen University, Shenzhen 518003, China
| | - Wenwen Yin
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Shuibo Pan
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Chenyangzi Dai
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Linhua Zhou
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Xiaoyu Jiang
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Chunyan Wang
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Junduan Wu
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China; Department of Guangxi Medical College, 8 Kunlun Road, Nanning 530023, China.
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Xiong P, Feng W, Lin Y. Child maltreatment and insomnia symptoms among Chinese university students: the buffering role of self-efficacy. J Sleep Res 2024:e14358. [PMID: 39376167 DOI: 10.1111/jsr.14358] [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: 09/08/2023] [Revised: 06/19/2024] [Accepted: 09/09/2024] [Indexed: 10/09/2024]
Abstract
Insomnia symptoms represent a significant public health concern, as it engenders substantial long-term health consequences. Considerable research has established the detrimental impacts of child maltreatment on sleep problems among university students. However, the role of self-efficacy in the association between childhood maltreatment and insomnia remains unclear. This study aimed to examine the associations between child maltreatment and insomnia symptoms among university students, and to investigate whether self-efficacy moderated the effects of child maltreatment on insomnia symptoms. A total of 2014 participants with random cluster sampling method were recruited from Jinan University in Guangzhou, China, from October 2022 to November 2022. Adjusting for covariates, the results of multiple logistic regression indicated that the participants with the experience of any type of child maltreatment (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.63-3.07), childhood emotional abuse (OR 2.58, 95% CI 1.95-3.41), childhood emotional neglect (OR 1.16, 95% CI 0.87-1.54), childhood physical abuse (OR 2.15, 95% CI 1.60-2.8), childhood physical neglect (OR 2.19, 95% CI 1.64-2.92), childhood sexual abuse (OR 1.98, 95% CI 1.46-2.68) were more likely to report insomnia symptoms than those without. Individuals reporting one-two types and three-five types of child maltreatment were 1.81 times (95% CI 1.30-2.52) and 3.77 times (95% CI 2.58-5.50) more likely to report insomnia symptoms than those reporting zero types of child maltreatment, respectively. Furthermore, robust linear regression analysis revealed that self-efficacy moderated the associations between child maltreatment and insomnia symptoms (β = 0.007, 95% CI 0.004-0.010). These findings underscore the need for integrated mental health education, support services, and faculty training to address the impact of child maltreatment on insomnia symptoms among university students. Policy recommendations include advocating for comprehensive mental health services, incorporating self-efficacy initiatives, and fostering community engagement for a holistic approach to student well-being.
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Affiliation(s)
- Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Wanmin Feng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Yusi Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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Zhang Y, Gong L, Feng Q, Hu K, Liu C, Jiang T, Zhang Q. Association between negative life events through mental health and non-suicidal self-injury with young adults: evidence for sex moderate correlation. BMC Psychiatry 2024; 24:466. [PMID: 38914977 PMCID: PMC11197180 DOI: 10.1186/s12888-024-05880-3] [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: 09/22/2023] [Accepted: 05/31/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) has exhibited an increasing trend in recent years and is now globally recognized as a major public health problem among adolescents and young adults. Negative life events (NLEs) are positively associated with NSSI. We sought to explore (1) whether sex plays a role in the risk of NLEs leading to NSSI and (2) the role played by mental health (MH). METHODS We adopted a multi-stage cluster sampling method to select college students across four grades from May to June 2022. Generalized linear models were used to evaluate the relationships between NLEs, sex, MH and NSSI, presented as incidence-rate ratios (RRs) with 95% confidence intervals (CIs). We examined the complex relationship between these variables using the PROCESS method for moderation analysis. RESULTS Following the exclusion of data that did not meet the study requirements, data from 3,578 students (mean age: 20.53 [± 1.65] years) were included. Poisson regression results indicate that high-level NLEs (RR = 0.110, 95%CI: 0.047-0.173) are associated with increased NSSI. Furthermore, interaction effects were observed among sex, NLEs and NSSI. MH and sex moderated the relationship between NLEs and NSSI. CONCLUSION Identifying risk factors for NSSI is also important when exploring the interaction between NLEs and MH given the potential for NSSI to significantly increase the risk of later psychopathological symptoms and substance abuse problems. In addition, the significance of sex differences in risk factors for NSSI should be determined. This study evaluated how the impact of NLEs on NSSI can be reduced among adolescents from multiple perspectives.
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Affiliation(s)
- Yi Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Li Gong
- Wuxi Huishan District People's Hospital, Wuxi, Jiangsu, 214187, China
| | - Qing Feng
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Keyan Hu
- The First Affiliated Hospital, College of Clinical Medicine of Henan, University of Science and Technology, Luoyang, Henan, 471003, China
| | - Chao Liu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Tian Jiang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
| | - Qiu Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
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Fu W, Li X, Ji S, Yang T, Chen L, Guo Y, He K. The Relationship Between Childhood Trauma and Non-Suicidal Self-Injury Behavior in Adolescents with Depression: The Mediating Role of Rumination. Psychol Res Behav Manag 2024; 17:1477-1485. [PMID: 38606089 PMCID: PMC11007121 DOI: 10.2147/prbm.s448248] [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: 11/18/2023] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
Objective Non-suicidal self-injury (NSSI) behavior is very common in adolescents with depression, and childhood trauma is considered one of the distal risk factors for its exacerbation. Rumination caused by adverse traumatic experiences, which can be transferred through NSSI behavior, can alleviate symptoms of depression in adolescents. The current research focuses on the relationship between the three, further exploring whether rumination is a mediator in the relationship between childhood trauma and NSSI behavior on the basis of previous studies, and provides some suggestions for future early intervention for adolescents with depression. Methods A total of 833 adolescent patients with depression who met the DSM-5 criteria for depressive episode were recruited from 12 hospitals in China. The Chinese version of the Function Assessment of Self-mutilation, Childhood Trauma Questionnaire, and Rumination Inventory were used as research tools. Results The scores of childhood trauma and rumination in adolescents with depression in the NSSI group were higher than those in the non-NSSI group. A Pearson's correlation analysis showed that childhood trauma was positively correlated with rumination (r=0.165, P<0.01), different types of childhood trauma were significantly positively correlated with rumination and its three factors, and these results were statistically significant. Rumination partially mediated the relationship between childhood trauma and NSSI behavior in depressed adolescent patients (effect size=0.002), and the effect in female participants (effect size=0.003), was greater than that in male participants (effect size=0.002). Conclusion Childhood trauma and rumination were key factors for NSSI behavior in adolescents with depression. Childhood trauma not only has a direct effect on NSSI behavior in adolescent depression, but also plays an indirect effect on NSSI behavior through rumination.
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Affiliation(s)
- Wenxian Fu
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Xinyi Li
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Sifan Ji
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Tingting Yang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychological Counseling department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Lu Chen
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychological Counseling department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Yaru Guo
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychological Counseling department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Kongliang He
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychological Counseling department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
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Wang Z, Xu Y, Zeng H. Trait rumination in post-stress growth among Chinese college students: the chain mediating effect of distress disclosure and perceived social support. Front Public Health 2023; 11:1265405. [PMID: 38074763 PMCID: PMC10701402 DOI: 10.3389/fpubh.2023.1265405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/01/2023] [Indexed: 12/18/2023] Open
Abstract
Background Rumination has emerged as a significant factor contributing to personal growth following periods of stress or trauma. The present study aimed to investigate the relationship between trait rumination and post-stress growth (PSG) within the context of Chinese college students who encounter mild stressors in their daily lives. Moreover, we aim to evaluate the potential mediating roles played by both distress disclosure and perceived social support in this dynamic relationship. Method All participants completed assessments using the Adolescent Self-Rating Life Events Checklist, Rumination Response Scale, Post-Stress Growth Inventory, Distress Disclosure Index, and Perceived Social Support Scale. Correlation and mediation analyses were conducted using SPSS PROCESS 4 MACRO. Results All students reported experiencing mild psychological impacts as a result of negative life events in the past year and displayed moderate levels of PSG. There was no significant correlation observed between the effects of negative life events and PSG. Significant negative correlations were found between trait rumination and distress disclosure, perceived social support, and PSG. Distress disclosure and perceived social support jointly operated as sequential mediators in the relationship between trait rumination and PSG among all the participants. Qualitative analyses revealed different correlation patterns of high- versus low-ruminator. Conclusion Trait rumination affects PSG both directly and indirectly, through its influence on distress disclosure and perceived social support. Our results emphasize the significance of actively participating in distress disclosure and nurturing a robust sense of social support to counteract the detrimental effects of rumination on post-stress growth among Chinese college students.
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Affiliation(s)
- Zengjian Wang
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yining Xu
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Huifang Zeng
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
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Zhang L, Wang W, Chen Y, Abudoula A, Wang X, Yuan X, Luo Y, Wu M, Ma L. Adverse childhood experiences, unhealthy lifestyle, and nonsuicidal self-injury: findings from six universities in Shaanxi province, China. Front Public Health 2023; 11:1199882. [PMID: 37397740 PMCID: PMC10308309 DOI: 10.3389/fpubh.2023.1199882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/18/2023] [Indexed: 07/04/2023] Open
Abstract
Background Nonsuicidal self-injury (NSSI) is a serious public health problem. The role of adverse childhood experiences (ACEs) and lifestyle on the risk for NSSI is still underexplored, especially among college students. We aimed to investigate the association of ACEs with the risk of NSSI, and effect modifications by lifestyle among college students. Methods A total of 18,723 college students from six universities were recruited through a multistage, random cluster sampling method in Shaanxi province, China. The Adverse Childhood Experiences International Questionnaire was used to assess ACEs for each participant, and the Chinese version of the Ottawa Self-injury Inventory was used to assess the presence or absence of NSSI behaviors. Information about lifestyle was collected by a self-designed questionnaire. The associations of NSSI with ACEs and lifestyle were analyzed using logistic regression models. Furthermore, we constructed a combination score of multiple lifestyles and evaluated whether lifestyle modified the effect of ACEs on the risk of NSSI. Results The prevalence of NSSI for the past 1 month, 6 months, and 12 months was 3.8, 5.3, and 6.5%, respectively. 82.6% of participants have reported experiencing at least one type of ACEs, and participants with higher levels of ACEs (≥4) were more likely to have higher odds of developing NSSI during the past 1 month (OR, 4.10; 95%CI, 3.38-4.97), 6 months (OR, 4.76; 95%CI, 4.03-5.62), and 12 months (OR, 5.62; 95%CI, 4.83-6.55), as compared with participants with low levels of ACEs (0-1). There were additive interactions between ACEs and lifestyle. Compared with participants with low levels of ACEs and healthy lifestyle, participants with high levels of ACEs and unhealthy lifestyle had the highest odds of NSSI during the past 1 month (OR, 5.56; 95%CI, 3.80-8.31), 6 months (OR, 6.62; 95%CI, 4.73-9.42), and 12 months (OR, 7.62; 95%CI, 5.59-10.52). Conclusion These results suggest that ACEs play an important role in the occurrence of NSSI among college students, especially in those with unhealthy lifestyle. Our findings may help develop targeted intervention strategies for the prevention of NSSI.
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Affiliation(s)
- Lei Zhang
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- Shaanxi Medical Association, Xi’an, China
- Shaanxi Provincial Health Industry Association Service Center, Xi’an, China
| | - Wenhua Wang
- Shaanxi Provincial Health Industry Association Service Center, Xi’an, China
| | - Yan Chen
- Changjun Kaifu Middle School, Changsha, China
| | - Aisimila Abudoula
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xue Wang
- Shaanxi Medical Association, Xi’an, China
| | - Xiaoxiao Yuan
- Shaanxi Provincial Health Industry Association Service Center, Xi’an, China
| | - Yi Luo
- Shaanxi Provincial Health Industry Association Service Center, Xi’an, China
| | - Mingyang Wu
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Le Ma
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
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