Jiang Zhongliang, Wang Zhiyi, Diao Qidi, Chen Jie, Tian Geng, Cheng Xiaojing, Zhao Miao, He Long, He Qiang, Sun Jin, Liu Jintong
Department of Child and Adolescent Psychiatry, Shandong Mental Health Center, Shandong University, Shandong, China.
Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong, China.
Ann Gen Psychiatry. 2022 Nov 19;21(1):45. doi: 10.1186/s12991-022-00423-0.
Adolescent non-suicidal self-injury (NSSI) is common and adolescence is the most common period of first self-injury, and the occurrence of NSSI is influenced by negative life events and emotional symptoms. The mediating role of emotional symptoms in the interaction between negative life events and NSSI has not been carefully investigated yet.
For middle school students in three schools in a Chinese province, the Adolescents Self-Harm Scale was used to investigate NSSI, the Adolescent Self-Rating Life Events Check List was used to investigate adolescent negative life events, and the Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to assess their emotional symptoms. After the description of general data and the test for differences between groups, the relationship between negative life events, emotional symptoms and NSSI was analyzed using Pearson correlation analysis. Structural equation modeling was used to analyze the mediating role of emotions in negative life events and NSSI.
A total of 2376 junior high school students completed this survey, which revealed an annual NSSI prevalence of 37.1% (n = 881) and a higher prevalence of NSSI among girls and rural adolescents. Among adolescents who developed NSSI, 67.4% (N = 594) used multiple means of self-injury. The most common means of self-injury was hair pulling (51.0%), and the most common NSSI purpose and external factors/events were venting bad emotions or feelings (57.5%) and poor academic performance (44.9%), respectively. Negative life events, emotional symptoms and NSSI were positively associated (P < 0.05). Structural equation modeling with negative life events, emotional symptoms and NSSI as variables showed that the model-fit index matched the data well, with RMSEA = 0.073, AGFI = 0.945, GFI = 0.980, CFI = 0.985, NFI = 0.982, TLI = 0.968, IFI = 0.985, and negative life events, emotional symptoms (anxiety, depression) and NSSI all had direct effects with standardized path coefficients of 0.16, 0.19, and 0.23, respectively, with negative life events playing an indirect role in NSSI through emotional symptoms and emotional symptoms playing an incomplete mediating role in negative life events and NSSI.
The prevalence of NSSI was higher among Chinese junior high school students. Both negative life events and emotional symptoms were direct risk factors for NSSI. In addition, negative life events were also indirect risk factors for NSSI, and emotional symptoms played an incomplete mediating role in the relationship between the effects of negative life events and NSSI. This indicates that the combination of reducing the frequency of negative life events while maintaining individual emotional stability during adolescent development can effectively reduce the prevalence of NSSI in adolescents.
青少年非自杀性自伤（NSSI）很常见，青春期是首次自伤最常见的时期，NSSI的发生受负面生活事件和情绪症状的影响。情绪症状在负面生活事件与NSSI相互作用中的中介作用尚未得到仔细研究。
针对中国某省三所学校的中学生，采用青少年自伤量表调查NSSI，采用青少年自评生活事件量表调查青少年负面生活事件，采用自评焦虑量表和自评抑郁量表评估其情绪症状。在描述一般数据并进行组间差异检验后，采用Pearson相关分析分析负面生活事件、情绪症状与NSSI之间的关系。采用结构方程模型分析情绪在负面生活事件与NSSI中的中介作用。
共有2376名初中生完成了本次调查，结果显示NSSI的年患病率为37.1%（n = 881），女孩和农村青少年中NSSI的患病率更高。在发生NSSI的青少年中，67.4%（N = 594）使用多种自伤手段。最常见的自伤手段是拔头发（51.0%），最常见的NSSI目的和外部因素/事件分别是发泄不良情绪或感受（57.5%）和学业成绩差（44.9%）。负面生活事件、情绪症状与NSSI呈正相关（P < 0.05）。以负面生活事件、情绪症状和NSSI为变量的结构方程模型显示，模型拟合指数与数据拟合良好，RMSEA = 0.073，AGFI = 0.945，GFI = 0.980，CFI = 0.985，NFI = 0.982，TLI = 0.968，IFI = 0.985，负面生活事件、情绪症状（焦虑、抑郁）和NSSI均有直接效应，标准化路径系数分别为0.16、0.19和0.23，负面生活事件通过情绪症状在NSSI中起间接作用，情绪症状在负面生活事件与NSSI之间起不完全中介作用。
中国初中生中NSSI的患病率较高。负面生活事件和情绪症状都是NSSI的直接危险因素。此外，负面生活事件也是NSSI的间接危险因素，情绪症状在负面生活事件与NSSI的关系中起不完全中介作用。这表明在青少年发育过程中，减少负面生活事件的发生频率并同时保持个体情绪稳定，两者相结合可以有效降低青少年中NSSI的患病率。
