Li Shuqin, Xu Huiqiong, Gao Xin, Wang Shanshan, Jiang Zhicheng, Sun Ying, Zhang Shichen, Tao Fangbiao, Wan Yuhui
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei 230032, China.
Wei Sheng Yan Jiu. 2022 Jan;51(1):18-31. doi: 10.19813/j.cnki.weishengyanjiu.2022.01.004.
The aim of this paper is to understand the relationship between patterns of adverse childhood experiences(ACEs), screen time and non-suicidal self-injury behaviors(NSSI) among middle school students.
Stratified cluster sampling method was used to select 14 500 middle school students(7347 boys and 7153 girls; 7247 junior high school students and 7253 senior high school students; 7619 urban students and 6881 rural students) from Shenzhen, Guiyang, Nanchang and Zhengzhou Cities. Questionnaire surveys were conducted using the child abuse questionnaire, household dysfunction questionnaire, non-suicidal self-injury behavior questionnaire and screen time items. The latent class analysis was used to evaluate the ACEs exposure patterns, and multivariable logistic regressions was used to analyze the association between patterns of ACEs, screen time levels and their combined effects with NSSI.
Latent class analysis indicated four distinct patterns of ACE exposure: highly ACEs group(6.3%), highly abuse and neglect group(21.4%), lowly ACEs group(26.8%), highly neglect group(45.5%). Those in highly ACEs(OR=4.65, 95%CI 3.73-5.80), highly abuse and neglect(OR=3.43, 95%CI 2.91-4.06) and highly neglect(OR=1.31, 95%CI 1.11-1.55) group had significantly higher risk of NSSI compared with those in lowly ACEs group(P<0.001). In study days(OR=1.72, 95%CI 1.42-2.08) and weekends(OR=1.42, 95%CI 1.27-1.60), high screen time were associated with increased rate of NSSI(P<0.01). There showed a trend toward increased risk of NSSI with increasing ACEs exposure and screen time level(P<0.05).
High ACEs exposure patterns and high screen time are associated with increased rate of NSSI. Reducing ACEs exposure and controlling screen time is beneficial to the prevention and control of NSSI in middle school students.
本文旨在了解中学生童年不良经历（ACEs）模式、屏幕使用时间与非自杀性自伤行为（NSSI）之间的关系。
采用分层整群抽样方法，从深圳、贵阳、南昌和郑州四市选取14500名中学生（男生7347名，女生7153名；初中生7247名，高中生7253名；城市学生7619名，农村学生6881名）。使用儿童虐待问卷、家庭功能障碍问卷、非自杀性自伤行为问卷和屏幕使用时间项目进行问卷调查。采用潜在类别分析评估ACEs暴露模式，多变量逻辑回归分析ACEs模式、屏幕使用时间水平及其与NSSI的联合效应之间的关联。
潜在类别分析表明存在四种不同的ACEs暴露模式：高ACEs组（6.3%）、高虐待和忽视组（21.4%）、低ACEs组（26.8%）、高忽视组（45.5%）。与低ACEs组相比，高ACEs组（OR=4.65，95%CI 3.73-5.80）、高虐待和忽视组（OR=3.43，95%CI 2.91-4.06）和高忽视组（OR=1.31，95%CI 1.11-1.55）的NSSI风险显著更高（P<0.001）。在学习日（OR=1.72，95%CI 1.42-2.08）和周末（OR=1.42，95%CI 1.27-1.60），高屏幕使用时间与NSSI发生率增加相关（P<0.01）。随着ACEs暴露和屏幕使用时间水平的增加，NSSI风险呈上升趋势（P<0.05）。
高ACEs暴露模式和高屏幕使用时间与NSSI发生率增加相关。减少ACEs暴露和控制屏幕使用时间有利于预防和控制中学生的NSSI。
