Fan Xiwang, Liu Yongshi, Liu Qingxin, 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 200124, China.
Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
J Affect Disord. 2025 Mar 15;373:421-428. doi: 10.1016/j.jad.2024.12.111. Epub 2025 Jan 2.
Childhood sexual abuse (CSA) is a well-established risk factor for a range of psychological and behavioral issues, including non-suicidal self-injury (NSSI), making it a critical area of research for understanding adolescent mental health. Despite its prevalence, the mechanisms underlying their relationship remain insufficiently explored. This study aims to explore the relationship between CSA and NSSI behavior, as well as the mediating role of social avoidance and the moderating role of perceived family support.
1737 Chinese adolescents with a mean age of 14.86 years (SD = 1.65) from hospitals' psychiatric departments in nine provinces of China were recruited to complete surveys on CSA experiences, NSSI behavior, and social support.
The results suggested that the effect of CSA on adolescent NSSI behavior was mediated by social avoidance, and the effect of CSA on social avoidance and NSSI behavior varied by the level of perceived family support. CSA led to social avoidance and increased risk for NSSI behavior. Higher levels of perceived family support had a protective effect, which reduced the motives of social avoidance and NSSI behavior.
These findings revealed the risk of CSA and emphasized the role of social avoidance as an NSSI motive and the protective role of perceived family support for adolescents experiencing CSA. The clinical implications emphasize the need for interventions targeting family support and alternative coping strategies in the Chinese context. Additionally, future research should explore the complexity of intra- and extra-familial abuse and the roles of peer and professional support.
儿童期性虐待(CSA)是一系列心理和行为问题的既定风险因素,包括非自杀性自伤(NSSI),使其成为理解青少年心理健康的关键研究领域。尽管其普遍存在,但其关系背后的机制仍未得到充分探索。本研究旨在探讨CSA与NSSI行为之间的关系,以及社交回避的中介作用和感知家庭支持的调节作用。
招募了来自中国九个省份医院精神科的1737名平均年龄为14.86岁(标准差=1.65)的中国青少年,以完成关于CSA经历、NSSI行为和社会支持的调查。
结果表明,CSA对青少年NSSI行为的影响通过社交回避介导,CSA对社交回避和NSSI行为的影响因感知家庭支持水平而异。CSA导致社交回避并增加NSSI行为的风险。较高水平的感知家庭支持具有保护作用,可减少社交回避和NSSI行为的动机。
这些发现揭示了CSA的风险,并强调了社交回避作为NSSI动机的作用以及感知家庭支持对经历CSA的青少年的保护作用。临床意义强调在中国背景下需要针对家庭支持和替代应对策略的干预措施。此外,未来的研究应探讨家庭内和家庭外虐待的复杂性以及同伴和专业支持的作用。