Qin Yuan, Liu Jiao, Duan Jiming, Yang Bo
Department of Psychiatry, Chongqing Mental Health Center, Chongqing, China.
School of Nursing, Zunyi Medical University, Zunyi, China.
Front Psychiatry. 2025 May 19;16:1581640. doi: 10.3389/fpsyt.2025.1581640. eCollection 2025.
Non-suicidal self-injury (NSSI) in adolescents represents a significant global public health challenge, with lifetime prevalence rates demonstrating a consistent upward trajectory. Current evidence indicates that NSSI conveys elevated risks for both physical complications and psychological comorbidities, while simultaneously imposing a substantial burden on primary caregivers.
This study applied latent profile analysis (LPA) to classify distinct caregiver burden profiles among adolescents with NSSI, identify modifiable determinants, and establish an empirical foundation for developing precision interventions stratified by burden type.
From August 2022 to May 2023, 385 caregivers of adolescents with NSSI in Sichuan Province, China, were selected as respondents and systematically assessed using six validated instruments: General Information Questionnaire, Family Burden Scale of Disease, Social Support Rating Scale, Generalized Anxiety Disorder 7-Item Scale, Patient Health Questionnaire-9, and Internalized Stigma of Mental Illness Scale. LPA with maximum likelihood estimation identified distinct caregiver burden profiles, and multinomial logistic regression to determine predictors of profile membership.
The caregiver burden among adolescents with NSSI can be identified into three profiles: low burden-family vulnerability profile (34.5%), moderate burden-mental health priority profile (36.6%), and high burden-economic preponderance profile (28.9%). Female caregivers ( = 3.760, = 0.005), rural residents ( = 3.666, = 0.027), diminished social support ( = 0.884, = 0.016), and elevated anxiety severity ( = 1.183, = 0.027) exhibited heightened vulnerability to the moderate burden-mental health priority profile. Heightened depression symptoms ( = 1.130, = 0.037) and stronger illness-related stigma ( = 1.063, 0.001) were disproportionately represented in both moderate burden-mental health priority profile and high burden-economic preponderance profile.
This study delineates three distinct caregiver burden profiles among adolescents with NSSI, alongside sociodemographic and clinical predictors of profile membership. Tailored interventions, such as rapid mental health service linkage for high-burden subgroups and family-centered psychoeducation, can mitigate these burdens through stratified support mechanisms.
青少年非自杀性自伤行为(NSSI)是一项重大的全球公共卫生挑战,其终生患病率呈持续上升趋势。现有证据表明,NSSI会增加身体并发症和心理共病的风险,同时给主要照顾者带来沉重负担。
本研究应用潜在剖面分析(LPA)对NSSI青少年的照顾者负担类型进行分类,识别可改变的决定因素,并为制定按负担类型分层的精准干预措施奠定实证基础。
2022年8月至2023年5月,选取中国四川省385名NSSI青少年的照顾者作为研究对象,使用6种经过验证的工具进行系统评估:一般信息问卷、疾病家庭负担量表、社会支持评定量表、广泛性焦虑障碍7项量表、患者健康问卷-9和精神疾病内化耻辱感量表。采用最大似然估计的LPA确定不同的照顾者负担类型,并通过多项逻辑回归确定类型归属的预测因素。
NSSI青少年的照顾者负担可分为三种类型:低负担-家庭脆弱型(34.5%)、中度负担-心理健康优先型(36.6%)和高负担-经济优势型(28.9%)。女性照顾者( = 3.760, = 0.005)、农村居民( = 3.666, = 0.027)、社会支持减少( = 0.884, = 0.016)和焦虑严重程度升高( = 1.183, = 0.027)对中度负担-心理健康优先型的易感性更高。抑郁症状加重( = 1.130, = 0.037)和更强的疾病相关耻辱感( = 1.063, 0.001)在中度负担-心理健康优先型和高负担-经济优势型中均不成比例地出现。
本研究描绘了NSSI青少年中三种不同的照顾者负担类型,以及类型归属的社会人口学和临床预测因素。针对性的干预措施,如为高负担亚组提供快速的心理健康服务联系和以家庭为中心的心理教育,可以通过分层支持机制减轻这些负担。