Wichstrøm Tove, Wichstrøm Lars
Norwegian University of Science and Technology, Trondheim, Norway.
Norwegian University of Science and Technology, Trondheim, Norway; St. Olavs Hospital, Trondheim, Norway.
J Am Acad Child Adolesc Psychiatry. 2024 Nov;63(11):1114-1122. doi: 10.1016/j.jaac.2023.12.013. Epub 2024 Feb 27.
Nonsuicidal self-injury (NSSI) is rare in childhood but becomes prevalent in adolescence, which suggests that early intervention might be indicated. As childhood predictors of NSSI in adolescence are largely unknown, identifying these predictors was the aim of this study.
In a birth cohort sample (n = 759) of Norwegian children, NSSI at 12, 14, or 16 years of age was regressed on predictors of NSSI at age 6 (parental factors: depression, parenting stress, negativity/hostility, emotional availability to the child; child factors: temperamental negative affectivity, emotion regulation, symptoms of emotional and behavioral disorders; external events: victimization from bullying, serious negative life events). Semistructured clinical interviews with adolescents and their parents were used to assess DSM-5-defined NSSI and NSSI disorder.
NSSI during the preceding 12 months at 12, 14, or 16 years of age was reported by 81 adolescents (10.0%, 95% CI 8.2-11.9), and NSSI disorder was reported by 20 adolescents (2.7%, 95% CI 1.9-3.8). In multivariable logistic regression analysis, female gender (odds ratio 11.6, 95% CI 4.0-33.5), parenting stress (odds ratio 4.8, 95% CI 1.4-16.5), and parental negativity/hostility (odds ratio 1.8, 95% CI 1.2-2.7) predicted NSSI, whereas child factors and external events were not predictive.
Parental factors when the child is 6 years of age-parenting stress and negativity/hostility toward the child-predict NSSI in adolescence. Universal and indicated programs targeting these aspects of parenting during childhood might reduce NSSI in adolescence.
Almost 1 in 4 adolescents engage in deliberate self-harm without wanting to die from it. However, childhood predictors of nonsuicidal self-injury are largely unknown. This study from Norway followed 759 children from birth until adolescence. The authors found that children who perceived their parents as more negative and hostile at 6 years old were at increased risk of engaging in self-injury when they became adolescents. Children whose parents reported more stress in the parenting role were also at increased risk of engaging in self-harm during adolescence. The authors conclude alleviating parental stress and improving parent-child relations at an early age might decrease the risk of adolescent self-harm.
DIVERSITY & INCLUSION STATEMENT: We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
非自杀性自伤行为(NSSI)在儿童期较为罕见,但在青少年期变得普遍,这表明可能需要早期干预。由于青少年期NSSI的儿童期预测因素大多未知,确定这些预测因素是本研究的目的。
在一个挪威儿童出生队列样本(n = 759)中,将12、14或16岁时的NSSI行为,对6岁时NSSI的预测因素(父母因素:抑郁、育儿压力、消极/敌意、对孩子的情感可及性;儿童因素:气质性消极情感、情绪调节、情绪和行为障碍症状;外部事件:受欺凌受害、严重负面生活事件)进行回归分析。采用对青少年及其父母的半结构式临床访谈来评估DSM-5定义的NSSI行为和NSSI障碍。
81名青少年(10.0%,95%可信区间8.2-11.9)报告在12、14或16岁前12个月内有NSSI行为,20名青少年(2.7%,95%可信区间1.9-3.8)报告有NSSI障碍。在多变量逻辑回归分析中,女性(比值比11.6,95%可信区间4.0-33.5)、育儿压力(比值比4.8,95%可信区间1.4-16.5)和父母消极/敌意(比值比1.8,95%可信区间1.2-2.7)可预测NSSI行为,而儿童因素和外部事件无预测作用。
儿童6岁时的父母因素——育儿压力和对孩子的消极/敌意——可预测青少年期的NSSI行为。针对儿童期育儿这些方面的普遍性和针对性项目可能会减少青少年期的NSSI行为。
近四分之一的青少年会故意自我伤害但并非想自杀。然而,非自杀性自伤行为的儿童期预测因素大多未知。这项来自挪威的研究对759名儿童从出生追踪到青少年期。作者发现,6岁时认为父母更消极和有敌意的儿童,在青少年期进行自我伤害的风险增加。父母报告在育儿角色中有更多压力的儿童,在青少年期进行自我伤害的风险也增加。作者得出结论,早期减轻父母压力和改善亲子关系可能会降低青少年自我伤害的风险。
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