Do Gender and Age Moderate the Relationship between Friendship Quality and Non-Suicidal Self-Injury in Community Children and Adolescents?

Do classroom relationships moderate the association between peer defending in school bullying and social-emotional adjustment?

Peer defending has been shown to protect bullied peers from further victimization and social-emotional problems. However, research examining defending behavior has demonstrated positive and negative social-emotional adjustment effects for defending students themselves. To explain these mixed findings, researchers have suggested that associations between defending behavior and social-emotional adjustment may be buffered by protective factors (i.e., defender protection hypothesis) or exacerbated by vulnerability or risk factors (i.e., defender vulnerability hypothesis). Consistent with these hypotheses, the present study aimed to investigate whether relationships with teachers and peers would moderate the association between defending behavior and social-emotional adjustment. This three-wave longitudinal study examined the association between peer nominated defending behavior and later self-reported depressive symptoms and self-esteem in 848 Belgian students in Grades 4-6 (53% girls; Mage = 10.61 years, SD = 0.90 at Wave 1). Peer nominated positive and negative teacher-student relationships (i.e., closeness and conflict) and peer relationships (i.e., acceptance and rejection) were included as moderators. Clustered multiple linear regression analyses demonstrated that defending behavior did not predict later depressive symptoms (β = -0.04, p = .80) or self-esteem (β = -0.19, p = .42). The lack of these associations could be explained by the defender protection and vulnerability hypotheses. However, contrary to our expectations, teacher-student closeness and peer acceptance did not play a protective role in the association between defending behavior and social-emotional adjustment (β = -1.48-1.46, p = .24-0.96). In addition, teacher-student conflict and peer rejection did not put defending students at risk for social-emotional maladjustment (β = -1.96-1.57, p = .54-0.97). Thus, relationships with teachers and peers did not moderate the association between defending behavior and later depressive symptoms and self-esteem.

Cumulative ecological risk and nonsuicidal self-injury in adolescents: The mediation of depression and the moderation of impulsiveness

BACKGROUND

This study is based on the biosocial model of nonsuicidal self-injury (NSSI), to explore the effects of cumulative ecological risk on adolescents' NSSI, the mediating effect of depression between cumulative ecological risk and adolescents' NSSI, and the moderating role of impulsiveness in this mediating pathway.

METHODS

A total of 16 508 adolescents, with 7903 males (47.9%), participated in the study and completed the Cumulative Ecological Risk Questionnaire, the Short Form of the Center for Epidemiological Studies Depression Scale, the Impulsiveness assessment, and the Nonsuicidal Self-Injury Scale.

RESULTS

(1) There was a significant positive correlation between cumulative ecological risk, depression, impulsiveness, and NSSI; (2) cumulative ecological risk significantly predicted adolescents' NSSI; (3) depression had a mediating effect between cumulative ecological risk and adolescents' NSSI; and (4) impulsiveness moderated both the effects of cumulative ecological risk on adolescents' depression and NSSI and the effects of depression on NSSI in adolescents.

CONCLUSIONS

Impulsiveness and depression are risk factors for adolescent NSSI and play a crucial role between cumulative ecological risk and NSSI in adolescents.

Prevalence of suicidal ideation and self-harm behaviours in children aged 12 years and younger: a systematic review and meta-analysis

BACKGROUND

Suicide in children is a pressing public health concern. The increasing number of deaths by suicide and emergency visits for suicidal ideation and self-harm in children might not be fully representative; it is likely that many more children are in distress but do not seek out help. We conducted a systematic review and meta-analysis of existing studies to quantify the prevalence of suicidal ideation and self-harm behaviours among children in the community aged 12 years and younger.

METHODS

In this systematic review and meta-analysis, we searched PsycINFO, MEDLINE, and Web of Science via OVID from database inception to Feb 28, 2022, for articles published in French or English that reported estimates of prevalence of suicidal ideation (including suicide planning) and self-harm behaviours (namely, self-harm, suicide attempts, and non-suicidal self-injury) in children aged 12 years and younger. Reference lists were also searched; case studies, qualitative studies, and health-care visit studies were excluded. The outcomes were suicidal ideation, suicide plan or attempts, and self-harm. We used a random-effects model to calculate the overall pooled prevalence of suicidal ideation and self-harm behaviours for all timeframes combined and for ever versus the past 12 months for suicidal ideation. We used the Joanna Briggs Institute Critical Appraisal tool to evaluate the risk of bias in each study. This study is registered with PROSPERO, CRD42020179041.

FINDINGS

28 articles, encompassing 30 studies overall, met the inclusion criteria, aggregating findings from 98 044 children (of whom 46 980 [50·5%] were girls and 46 136 [49·5%] were boys; six articles did not report sex or gender) aged 6-12 years. The pooled prevalence estimate was 7·5% (95% CI 5·9-9·6) for suicidal ideation from 28 studies and 2·2% (2·0-2·5) for suicide planning from three studies. The pooled prevalence was 1·4% (0·4-4·7) for self-harm from four studies, 1·3% (1·0-1·9) for suicide attempt from six studies, and 21·9% (6·2-54·5) for non-suicidal self-injury from two studies. The prevalence of suicidal ideation was higher in studies that included child-reported outcomes (10·9% [95% CI 8·1-14·5] for child only and 10·4% [6·8-15·5] for child and parent combined) than for parent-only reported outcomes (4·7% [3·4-6·6]; p=0·0004). The prevalence of suicidal ideation and self-harm behaviours was similar in boys and girls (suicidal ideation, 7·9% [95% CI 5·2-12·0] for boys vs 6·4% [3·7-10·7] for girls; self-harm behaviours, 3·5% [1·6-7·2] for boys vs 3·0% [1·4-6·4%] for girls). Detailed ethnicity data were not available. High heterogeneity was identified across estimates (I²>90%), which was not well explained by the characteristics of the studies.

INTERPRETATION

A high number of children in the general population can experience suicidal ideation and self-harm behaviours, thus underlining the need for more research on childhood suicide, including developmentally appropriate preventive strategies, such as youth-nominated support teams or dialectical behavioural therapy.

FUNDING

Canada Research Chair in Youth Mental Health and Suicide Prevention.

Associations between coping styles, gender, their interaction and non-suicidal self-injury among middle school students in rural west China: A multicentre cross-sectional study

BACKGROUND

To investigate the association between coping styles, gender, their interactions and non-suicidal self-injurious (NSSI) behaviors among middle school students in rural western China under COVID-19.

METHODS

A multicentre cross-sectional study method was used to conduct an online survey of 8,361 students from 23 middle schools in the northern Sichuan region by clustering sampling, using the General Information Questionnaire, the Ottawa Self-Injury Inventory, and the Coping Style Scale for Middle School Students.

RESULTS

The past year prevalence of NSSI among middle school students in rural west China was 5.7%. The differences in scores between those with and without NSSI on all dimensions of coping styles were statistically significant (p < 0.001). Multivariate logistic regression analysis revealed that vocational high school (OR = 1.67), girls (OR = 2.5), single parent with divorced parents (OR = 1.89), remarriage with divorced parents (OR = 1.81), and tolerance (OR = 1.17), venting emotions (OR = 1.15) and fantasy/denial (OR = 1.07) in coping styles may increase the risk of NSSI among middle school students, while problem solving (OR = 0.9) and seeking social support (OR = 0.9) among coping styles may reduce the risk of NSSI among middle school students. The interaction results show that gender has a moderating role in the process of endurance, avoidance, venting of emotions, and fantasy/denial influencing non-suicidal self-injury in middle school students.

CONCLUSION

There is an association between coping styles and self-injury among middle school students in rural areas in western China, with gender playing a moderating role. Active attention should be paid to students' coping styles and encouraging them to adopt positive coping styles as well as avoid negative coping styles, especially in the case of girls, which can help prevent self-injury.