Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China.
The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China.
BMC Public Health. 2021 Nov 9;21(1):2055. doi: 10.1186/s12889-021-12153-1.
A significant association between self-harm (SH) and suicide ideation (SI) has been found in Chinese left-behind children (LBC). Existing literature suggests that resilience might be a mediator in this association. However, this hypothesis has not been effectively discussed. The major aim of our study is to analyze the possible mediation of resilience in SH-SI association in Chinese LBC.
A population-based clustering sampling survey of 2619 LBC was conducted in southwestern China Yunnan province. Self-developed structured questionnaire was used to collect relevant information. Univariate and multivariate Logistic regression models were applied to estimate the associations between SH and SI, resilience and SI, and SH and resilience. Path analysis was adopted to measure the mediation of resilience, as well as its 5 dimensions, in the association between SH and SI. A subgroup analysis was further done to explore the mediation of resilience in the associations between SH severity and SI, SH repetition and SI, among self-harmed LBC.
Compared with LBC who reported no SH behaviors, the odds ratio (OR) for SI was 3.37 (95% CI: 2.63-4.31) among self-harmed LBC. Based on the path model, resilience significantly mediated a quarter of the total association between SH and SI. Among the 5 dimensions of resilience, emotion regulation, interpersonal assistance, and family support were the strongest mediators. Subgroup analysis revealed that, the mediation of resilience was only significant for SH severity and SI.
Resilience played as a prominent mediator in SH-SI association among Chinese LBC. Resilience-centered intervention measures could be considered to reduce suicidal risk of this disadvantageous group.
在中国留守儿童（LBC）中，已经发现自我伤害（SH）和自杀意念（SI）之间存在显著关联。现有文献表明，韧性可能是这种关联的中介。然而，这一假设尚未得到有效讨论。我们的主要研究目的是分析在中国 LBC 中，韧性在 SH-SI 关联中可能起到的中介作用。
在中国西南部云南省进行了一项基于人群的聚类抽样调查，共调查了 2619 名 LBC。使用自行设计的结构化问卷收集相关信息。采用单变量和多变量 Logistic 回归模型来估计 SH 和 SI、韧性和 SI 以及 SH 和韧性之间的关联。采用路径分析来衡量韧性及其 5 个维度在 SH 和 SI 之间关联中的中介作用。进一步进行亚组分析，以探讨韧性在 SH 严重程度和 SI、SH 重复和 SI 之间关联中的中介作用。
与未报告 SH 行为的 LBC 相比，有 SH 行为的 LBC 发生 SI 的比值比（OR）为 3.37（95%CI：2.63-4.31）。基于路径模型，韧性显著介导了 SH 和 SI 之间总关联的四分之一。在韧性的 5 个维度中，情绪调节、人际帮助和家庭支持是最强的中介因素。亚组分析显示，韧性的中介作用仅在 SH 严重程度和 SI 之间显著。
韧性在中国 LBC 的 SH-SI 关联中起着重要的中介作用。可以考虑以韧性为中心的干预措施来降低这一弱势群体的自杀风险。
