Liu Z Z, Wang X T, Liu X C, Wang Z Y, An D, Jia C X
Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Dec 10;40(12):1573-1577. doi: 10.3760/cma.j.issn.0254-6450.2019.12.013.
Non-suicidal self-injury (NSSI) in adolescents appeared prevalent and multifactorial. This study was to examine the associations between exposure to suicidal behaviors and NSSI in the Chinese adolescents. Participants included for analyses were 5 154 adolescent students who participated in the baseline survey in 2015 and the first follow-up survey in 2016 of the Shandong Adolescent Behavior and Health Cohort, but with no history of NSSI at the baseline survey. A self-administered structured questionnaire was used to collect data on demographics, behavioral and emotional problems, lifetime and last-year NSSI. Data on the history of exposure to suicide attempt or death of a family member, friend, or close acquaintance were also collected. Multivariate logistic regression methods were used to examine the associations between exposure to suicidal behaviors and NSSI. In the baseline survey, mean age of the 5 154 participants was (14.49±1.48) years, with 48.5 of the participants as girls. Of the participants, 9.0 reported having been exposed to suicidal behaviors, including 6.0 reported to suicide attempt, 4.9 to suicide death, 7.3 to suicidal behaviors of friends/close acquaintances, and 3.1 to suicidal behaviors of relatives. The prevalence rates of NSSI in the last year were significantly higher in adolescents who had been exposed to suicidal behaviors than those who had not (<0.05). Results from the multivariate logistic regressions showed that exposure to suicide death (=1.91, 95: 1.22-3.01) or to suicidal behaviors of relatives (=1.79, 95: 1.02-3.12) were both significantly associated with the increased risk of NSSI. Experiences related to exposure to suicide-death or suicidal behaviors of relatives were associated with increased risk of NSSI in adolescents. After the suicide events, psychological counseling and health education programs set for high-risk groups were helpful in promoting physical and mental health and preventing the attempt of self-injury in teenagers.
青少年非自杀性自伤行为（NSSI）似乎普遍存在且受多种因素影响。本研究旨在探讨中国青少年中接触自杀行为与NSSI之间的关联。纳入分析的参与者为5154名青少年学生，他们参加了2015年的山东青少年行为与健康队列基线调查以及2016年的首次随访调查，但在基线调查时无NSSI病史。采用自填式结构化问卷收集人口统计学、行为和情绪问题、终生及去年NSSI的数据。还收集了接触自杀未遂或家庭成员、朋友或亲密熟人死亡史的数据。采用多因素逻辑回归方法检验接触自杀行为与NSSI之间的关联。在基线调查中，5154名参与者的平均年龄为（14.49±1.48）岁，其中48.5%为女孩。在参与者中，9.0%报告曾接触过自杀行为，包括6.0%报告有自杀未遂经历、4.9%报告有自杀死亡经历、7.3%报告有朋友/亲密熟人的自杀行为、3.1%报告有亲属的自杀行为。去年接触过自杀行为的青少年中NSSI的患病率显著高于未接触过的青少年（<0.05）。多因素逻辑回归结果显示，接触自杀死亡（=1.91，95%CI：1.22 - 3.01）或亲属的自杀行为（=1.79，95%CI：1.02 - 3.12）均与NSSI风险增加显著相关。与接触自杀死亡或亲属自杀行为相关的经历与青少年NSSI风险增加有关。自杀事件发生后，为高危人群设置的心理咨询和健康教育项目有助于促进身心健康，预防青少年自伤行为的发生。
