Tang Jie, Yang Wei, Ahmed Niman Isse, Ma Ying, Liu Hui-Yan, Wang Jia-Ji, Wang Pei-Xi, Du Yu-Kai, Yu Yi-Zhen
From the School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong (JT, PXW, JJW); Department of Nutrition and Food Hygiene, and MOE Key Lab of Environment and Health (WY); Department of Child, Adolescence & Women Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei (NIA, YKD & YZY); and Guangzhou Women and Children Medical Center (YM & HYL), Guangzhou, Guangdong, China.
Medicine (Baltimore). 2016 Mar;95(9):e2637. doi: 10.1097/MD.0000000000002637.
Stressful life events have been implicated in the etiology of kinds of psychopathology related to nonsuicidal self-injury (NSSI); however, few studies have examined the association between NSSI and stressful life events directly in Chinese school adolescents. In this study, we aim to estimate the prevalence rate of NSSI and examine its association with stressful life events in Southern Chinese adolescents. A total sample of 4405 students with age ranged from 10 to 22 years was randomly selected from 12 schools in 3 cities of Guangdong Province, China. NSSI, stressful life events, self-esteem, emotional management, and coping methods were measured by structured questionnaires. Multinomial logistic regression was used to examine the association of NSSI with stressful life events. Results showed the 1 year self-reported NSSI was 29.2%, with 22.6% engaged in "minor" NSSI (including hitting self, pulling hair, biting self, inserting objects under nails or skin, picking at a wound) and 6.6% in "moderate/sever" NSSI (including cutting/carving, burning, self-tattooing, scraping, and erasing skin). Self-hitting (15.9%), pulling hair out (10.9%), and self-inserting objects under nails or skin picking areas to dram blood (18.3%) were the most frequent types of NSSI among adolescents. Results also showed that "Minor NSSI" was associated with stressful life events on interpersonal, loss and health adaption, and "moderate/severe NSSI" was associated with life events on interpersonal, health adaption in Southern Chinese adolescents, even after adjusted for sex, age, residence, self-esteem, coping style, and emotional management. Results further suggested stressful life events were significantly associated with less risk of NSSI in those who had good emotional management ability.
压力性生活事件被认为与各类与非自杀性自伤（NSSI）相关的精神病理学病因有关；然而，很少有研究直接在中国青少年学生中检验NSSI与压力性生活事件之间的关联。在本研究中，我们旨在估计中国南方青少年中NSSI的患病率，并检验其与压力性生活事件的关联。从中国广东省3个城市的12所学校中随机抽取了4405名年龄在10至22岁之间的学生作为总样本。通过结构化问卷测量NSSI、压力性生活事件、自尊、情绪管理和应对方式。采用多项逻辑回归分析来检验NSSI与压力性生活事件之间的关联。结果显示，1年内自我报告的NSSI发生率为29.2%，其中22.6%的人有“轻度”NSSI（包括击打自己、拔头发、咬自己、在指甲或皮肤下插入物体、抠伤口），6.6%的人有“中度/重度”NSSI（包括切割/刻划、灼烧、自我纹身、刮擦和擦皮）。青少年中最常见的NSSI类型是自我击打（15.9%）、拔头发（10.9%）以及在指甲或皮肤抠破处插入物体以引出血液（18.3%）。结果还表明，即使在对性别、年龄、居住地、自尊、应对方式和情绪管理进行调整后，“轻度NSSI”与中国南方青少年在人际、丧失和健康适应方面的压力性生活事件相关，“中度/重度NSSI”与人际、健康适应方面的生活事件相关。结果进一步表明，对于情绪管理能力良好的人，压力性生活事件与较低的NSSI风险显著相关。
