Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada.
Faculty of Education, Western University, 1137 Western Road, London, ON N6G 1G7, Canada.
Child Abuse Negl. 2017 Jul;69:163-176. doi: 10.1016/j.chiabu.2017.04.011. Epub 2017 May 3.
The objectives of this study were to examine the prevalence of, and determine the effect of adverse childhood experiences on non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. Data for this study were obtained from the interRAI Child and Youth Mental Health dataset. A total of 2038 children and adolescents aged 8-18 years (M=12.49; SD=2.88, 61.1% males) were analyzed. Binary logistic regression was fitted to identify predictors of non-suicidal self-injury as a function of adverse childhood experiences, depression, and social support while simultaneously controlling for age, gender, type of patient, legal guardianship, marital status of parents/caregivers, history of foster family placement, and mental health diagnoses. Of the 2038 children and adolescents examined, 592 (29%) of this clinical sample engaged in non-suicidal self-injury. In the multivariate logistic regression model, children and adolescents who were physically abused had 49% higher odds of engaging in non-suicidal self-injury and children and adolescents who were sexually abused had 60% higher odds of engaging in non-suicidal self-injury, when compared to their non-abused counterparts. Other predictors of non-suicidal self-injury include: older age, female gender, inpatient status, depression, attention deficit-hyperactivity disorder, disruptive behavior disorder, and mood disorders. Children and adolescents who had some form of social support had a 26% decrease in the odds of engaging in non-suicidal self-injury. Assessment procedures for indicators of mental health, particularly among children and adolescents with a history of adverse childhood experiences, should also take into account non-suicidal self-injury. In addition to bolstering social support networks, addressing depression and related emotion regulation skills in childhood may help prevent future non-suicidal self-injury behaviors.
本研究的目的是调查儿童和青少年在社区和住院心理健康机构就诊时，遭受不良童年经历的普遍性，并确定其对非自杀性自伤的影响。本研究的数据来自 interRAI 儿童和青少年心理健康数据集。共分析了 2038 名 8-18 岁的儿童和青少年（M=12.49；SD=2.88，61.1%为男性）。采用二元逻辑回归分析确定非自杀性自伤的预测因素，其函数为不良童年经历、抑郁和社会支持，同时控制年龄、性别、患者类型、法定监护权、父母/照顾者的婚姻状况、寄养家庭经历和心理健康诊断。在被检查的 2038 名儿童和青少年中，29%（592 名）的临床样本有非自杀性自伤行为。在多变量逻辑回归模型中，与未受虐待的儿童和青少年相比，遭受身体虐待的儿童和青少年非自杀性自伤的可能性高 49%，遭受性虐待的儿童和青少年非自杀性自伤的可能性高 60%。非自杀性自伤的其他预测因素包括：年龄较大、女性、住院状态、抑郁、注意力缺陷多动障碍、破坏性行为障碍和情绪障碍。有某种形式的社会支持的儿童和青少年，非自杀性自伤的可能性降低 26%。针对心理健康指标的评估程序，特别是针对有不良童年经历的儿童和青少年，也应考虑到非自杀性自伤。除了加强社会支持网络外，在儿童时期解决抑郁和相关的情绪调节技能问题，可能有助于预防未来的非自杀性自伤行为。
