Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China.
Centers for Disease Control and Prevention of Lijin County, Lijin 257400, China.
J Affect Disord. 2018 Jan 15;226:287-293. doi: 10.1016/j.jad.2017.10.010. Epub 2017 Oct 3.
Suicide attempts (SA) and non-suicidal self-injury (NSSI) are prevalent in adolescents and important risk factors of suicide death. Both SA and NSSI are associated with multiple psychosocial, behavioral, biological and genetic factors. This study examined similarities and differences in psychological vulnerability and internalizing and externalizing problems between adolescents with SA and NSSI.
Participants consisted of 11,831 students and had a mean age of 14.97 (SD = 1.46) years. Students completed a structured questionnaire to report their demographic information, psychological characteristics, internalizing and externalizing problems, SA and NSSI. Based on the history of NSSI and SA in the last year, the sample was divided into four groups: non-self-harm (NSH), NSSI only, SA only, and NSSI+SA. Multivariate analyses of covariance and post-hoc pairwise comparisons were performed for multiple comparisons.
Compared with NSH group, adolescents with either NSSI or SA scored significantly higher on trait anger, impulsiveness, hopelessness, internalizing and externalizing problems. NSSI+SA group and SA only group scored significantly higher than NSSI only group but both did not score significantly different on most psychological and behavioral variables.
Limitations include reliance on self-reported measures and cross-sectional survey.
Psychological and behavioral profiles between adolescents with SA and NSSI are similar but are more severe in suicide attempters. The findings highlight the necessity of assessing psychological and behavioral problems for prevention and early intervention of adolescent self-harm.
自杀未遂(SA)和非自杀性自伤(NSSI)在青少年中很常见,是自杀死亡的重要危险因素。SA 和 NSSI 均与多种心理社会、行为、生物和遗传因素有关。本研究旨在探讨 SA 和 NSSI 青少年之间心理脆弱性以及内化和外化问题的异同。
参与者包括 11831 名学生,平均年龄为 14.97 岁(SD=1.46)。学生完成了一份结构化问卷,以报告其人口统计学信息、心理特征、内化和外化问题、SA 和 NSSI。根据过去一年中 NSSI 和 SA 的历史,将样本分为四组:非自伤(NSH)、仅 NSSI、仅 SA 和 NSSI+SA。采用多元协方差分析和事后两两比较进行多重比较。
与 NSH 组相比,有 NSSI 或 SA 的青少年在特质愤怒、冲动、绝望、内化和外化问题上的得分明显更高。NSSI+SA 组和 SA 组的得分明显高于 NSSI 组,但在大多数心理和行为变量上均无显著差异。
本研究的局限性包括依赖于自我报告的测量和横断面调查。
SA 和 NSSI 青少年的心理和行为特征相似,但自杀未遂者更严重。研究结果强调了评估青少年自伤的心理和行为问题对于预防和早期干预的必要性。