Zhao Yunhan, Zhao Xudong, Zhou Yongjie, Liu Liang
Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China.
Clinical Research Center for Mental Disorders, Chinese-German Institute of Mental Health, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China.
Front Psychiatry. 2024 May 23;15:1378492. doi: 10.3389/fpsyt.2024.1378492. eCollection 2024.
Non-suicidal self-injury (NSSI) has become a common clinical problem that severely threatens the mental and physical health of Chinese adolescents. This study explores the mediation effects of NSSI functions on the relationship between anxiety and NSSI frequency among depressed Chinese adolescents as well as the sex differences in the mediating effects.
In this study, a cross-sectional survey method was used to obtain data of 1773 adolescent patients with major depressive disorders from over 20 specialized psychiatric hospitals across multiple provinces in China. A self-designed questionnaire for demographic information, the Chinese version of Functional Assessment of Self- Mutilation (C-FASM), and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were employed to investigate demographic data, NSSI frequency, NSSI functions, and anxiety and to analyze the mediating effects of NSSI functions on the association between anxiety and NSSI frequency among adolescents of different sexes.
A total of 316 male patients and 1457 female patients were investigated. Female patients had a higher NSSI frequency (Z=3.195, P=0.001) and higher anxiety scores than did male patients (Z=2.714, P=0.007). Anxiety had a stronger positive predictive effect on the NSSI frequency in females (OR = 1.090) than in males (OR = 1.064). For male patients, the emotion regulation function in NSSI motivation played a full mediating role in the association between anxiety and NSSI frequency. For female patients, the emotion regulation and social avoidance functions in NSSI functions played a partial mediating role between anxiety and NSSI frequency.
There are sex differences in the mediating role of NSSI functions of depressed adolescents in the association between anxiety and NSSI frequency. When experiencing anxiety, both males and females may engage in NSSI behaviors as a means to regulate their emotions. For females, anxiety can directly predict NSSI frequency, and they may attempt NSSI to achieve the purpose of rejecting others. In the face of anxiety among depressed adolescents of different sexes, developing different emotional regulation methods and behavioral regulation strategies may be critical in preventing their NSSI behaviors.
非自杀性自伤（NSSI）已成为一个常见的临床问题，严重威胁着中国青少年的身心健康。本研究探讨NSSI功能在抑郁的中国青少年焦虑与NSSI频率关系中的中介作用以及中介作用的性别差异。
本研究采用横断面调查方法，收集了来自中国多个省份20多家专业精神病医院的1773例青少年重度抑郁症患者的数据。采用自行设计的人口学信息问卷、中文版自残功能评估量表（C-FASM）和7项广泛性焦虑障碍量表（GAD-7）来调查人口学数据、NSSI频率、NSSI功能和焦虑情况，并分析NSSI功能在不同性别青少年焦虑与NSSI频率关联中的中介作用。
共调查了316例男性患者和1457例女性患者。女性患者的NSSI频率更高（Z=3.195，P=0.001），且焦虑得分高于男性患者（Z=2.714，P=0.007）。焦虑对女性NSSI频率的正向预测作用（OR = 1.090）强于男性（OR = 1.064）。对于男性患者，NSSI动机中的情绪调节功能在焦虑与NSSI频率的关联中起完全中介作用。对于女性患者，NSSI功能中的情绪调节和社交回避功能在焦虑与NSSI频率之间起部分中介作用。
抑郁青少年NSSI功能在焦虑与NSSI频率关联中的中介作用存在性别差异。当感到焦虑时，男性和女性都可能通过NSSI行为来调节情绪。对于女性，焦虑可直接预测NSSI频率，她们可能试图通过NSSI来达到拒绝他人的目的。面对不同性别的抑郁青少年的焦虑情绪，制定不同的情绪调节方法和行为调节策略对于预防他们的NSSI行为可能至关重要。
