Zhang Yang, Suo Xingbo, Wang Xinqi, Xu Jingjing, Xu Wangwang, Pan Liangke, Gao Jin
Department of Clinical Psychology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, People's Republic of China.
Department of Psychosomatic Medicine, The 1st Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, People's Republic of China.
Psychol Res Behav Manag. 2025 Apr 24;18:1033-1047. doi: 10.2147/PRBM.S513241. eCollection 2025.
Non-suicidal self-injury (NSSI) in adolescents has a complex etiology and a wide range of negative consequences. This study aimed to assess the interactions between NSSI and sleep quality and cytokines and explore the association of these factors with cognitive flexibility.
A cross-sectional survey was conducted from January 2022 to September 2024 in Qingdao, China. Adolescent Non-Suicidal Self-Injury Assessment Questionnaire, Pittsburgh Sleep Quality Index, and Wisconsin Card Sorting Test 128 card version were used to assess the NSSI, sleep quality, and cognitive flexibility. Levels of 12 serum cytokines were measured. Network analysis was performed by R software (version 4.4.1) to identify the central nodes and bridging symptoms of the network and all nodes' association with cognitive flexibility.
A total of 337 adolescents with depressive disorders were included in the study. In the NSSI-Sleep Quality-Cytokines Network "Intentional scratches", "IL-12p70", and "Intentionally hitting oneself with fists or harder objects" were central nodes in the network. Furthermore, sleep-related variables such as "Sleep disturbance" and "Sleep duration" were identified as bridge symptoms. No direct association between NSSI and cognitive flexibility was observed.
The cross-sectional design, reliance on self-reported data, and restricted geographic sample limit the ability to establish causal relationships and generalize the findings.
IL-12p70 plays a significant role in the development of NSSI among adolescents with depressive disorders. Sleep problems facilitate the interaction between NSSI and cytokines. Cognitive flexibility may be related to NSSI through indirect pathways.
青少年非自杀性自伤行为（NSSI）病因复杂，会产生广泛的负面后果。本研究旨在评估NSSI与睡眠质量及细胞因子之间的相互作用，并探讨这些因素与认知灵活性的关联。
于2022年1月至2024年9月在中国青岛进行了一项横断面调查。采用青少年非自杀性自伤行为评估问卷、匹兹堡睡眠质量指数和威斯康星卡片分类测验128张卡片版来评估NSSI、睡眠质量和认知灵活性。检测了12种血清细胞因子的水平。使用R软件（版本4.4.1）进行网络分析，以识别网络的中心节点和桥梁症状以及所有节点与认知灵活性的关联。
本研究共纳入337名患有抑郁症的青少年。在NSSI - 睡眠质量 - 细胞因子网络中，“故意划伤”“IL - 12p70”和“用拳头或更硬的物体故意击打自己”是网络中的中心节点。此外，“睡眠障碍”和“睡眠时间”等与睡眠相关的变量被确定为桥梁症状。未观察到NSSI与认知灵活性之间存在直接关联。
横断面设计、依赖自我报告数据以及地理样本受限，限制了建立因果关系和推广研究结果的能力。
IL - 12p70在患有抑郁症的青少年NSSI的发生发展中起重要作用。睡眠问题促进了NSSI与细胞因子之间的相互作用。认知灵活性可能通过间接途径与NSSI相关。
