Zhou Linqi, Qiao Changyuan, Huang Jialing, Lin Jian, Zhang Haisheng, Xie Jian, Yuan Yonggui, Hu Changchun
School of the Fourth Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.
Department of Clinical Psychology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, People's Republic of China.
Neuropsychiatr Dis Treat. 2024 Feb 29;20:415-428. doi: 10.2147/NDT.S444729. eCollection 2024.
Previous studies have demonstrated a strong association between recent stressful life events and non-suicidal self-injury (NSSI) among adolescents. Internalizing symptoms and difficulty in emotion regulation (DER) may mediate this relationship. This study aimed to investigate the relationship between recent stressful life events and NSSI severity in adolescents and the potential moderating role of internalizing symptoms and DER.
A total of 224 adolescent inpatients (78.6% female) participated in the study, with an age range of 12-18 years old. Data on recent stressful life events, internalizing symptoms, DER, and NSSI behaviors were collected using a clinician-rated questionnaire. A structural equation model was used to test the hypothesized model.
The rate of NSSI reporting among adolescents in the past 12 months was 65.18%. Recent stressful life events were found to be directly associated with NSSI severity ( = 0.128, = 0.023). A chain-mediating effect between recent stressful life events and NSSI was also confirmed ( = 0.034, = 0.023), with DER and internalizing symptoms playing a chain-mediating role and DER having a significantly indirect association with NSSI through internalizing symptoms.
Recent stressful life events appear to play a role in the etiology of NSSI, particularly punishment and interpersonal relationship events that warrant special attention. DER and internalizing symptoms play a chain-mediating role in the relationship between life events and NSSI. Reducing recent stressful life events, screening for internalizing symptoms, and improving emotion regulation may decrease NSSI behavior among adolescents.
先前的研究表明，青少年近期的应激性生活事件与非自杀性自伤（NSSI）之间存在密切关联。内化症状和情绪调节困难（DER）可能介导这种关系。本研究旨在探讨青少年近期应激性生活事件与NSSI严重程度之间的关系，以及内化症状和DER的潜在调节作用。
共有224名青少年住院患者（78.6%为女性）参与了本研究，年龄范围为12 - 18岁。使用临床医生评定问卷收集有关近期应激性生活事件、内化症状、DER和NSSI行为的数据。采用结构方程模型对假设模型进行检验。
过去12个月青少年中报告NSSI的发生率为65.18%。发现近期应激性生活事件与NSSI严重程度直接相关（β = 0.128，p = 0.023）。还证实了近期应激性生活事件与NSSI之间存在链式中介效应（β = 0.034，p = 0.023），DER和内化症状起链式中介作用，且DER通过内化症状与NSSI存在显著间接关联。
近期应激性生活事件似乎在NSSI的病因中起作用，特别是惩罚和人际关系事件值得特别关注。DER和内化症状在生活事件与NSSI的关系中起链式中介作用。减少近期应激性生活事件、筛查内化症状并改善情绪调节可能会减少青少年的NSSI行为。
