青少年非自杀性自伤行为的家庭影响因素分析

郭霜霜; 焦婷; 马颖; 唐杰

doi:10.16835/j.cnki.1000-9817.2022.05.030

青少年非自杀性自伤行为的家庭影响因素分析

doi: 10.16835/j.cnki.1000-9817.2022.05.030

广州医科大学公共卫生学院，广东 511436

基金项目:

国家自然基金项目 81773457

详细信息

作者简介:
郭霜霜(1997-), 女，湖北襄阳人，在读硕士，主要研究方向为青少年危险性行为的病因和预防

通讯作者:
唐杰，Email：gytanjie@163.com

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中图分类号: B844.2 G478 G444
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- 被引次数: 0
出版历程
- 收稿日期: 2021-11-20
- 修回日期: 2021-12-31
- 网络出版日期: 2022-05-20
- 刊出日期: 2022-05-25

Household determinants of non-suicidal self-injury among adolescents

School of Public Health, Guangzhou Medical University, Guangzhou (511436), China

摘要

摘要: 目的分析青少年非自杀性自伤行为(NSSI)的家庭影响因素, 为制定青少年自伤行为干预策略提供科学依据。方法采用分层随机整群抽样方法, 在黑龙江、安徽、湖北、云南、广东5省抽取15 623名11~20岁中学生为研究对象, 采用问卷评估青少年NSSI行为的频率, 以及家庭相关的影响因素。结果最近1年内至少发生1次以上自伤行为者占28.8%, 其中1~4次(偶有自伤行为)者占17.6%, 5次及以上(反复自伤行为)者占11.2%。单因素分析结果显示, 是否为独生子女、家庭类型、主要照料人文化程度、家庭教养方式、家庭人均月收入以及是否有精神疾病家族史与青少年偶有自伤行为及反复自伤行为均有相关性(χ²=6.30~12.16, P值均 < 0.05)。控制性别、年龄、年级、民族, 情绪管理、心理韧性、孤独感、社会支持等因素后, 是否独生子女、家庭教养方式仍与偶有自伤行为均呈正相关(OR值分别为1.11, 1.34, P值均 < 0.05);是否独生子女、主要照料人文化程度和家庭教养方式与反复自伤行为仍有相关性(OR值分别为1.19, 0.69, 1.57, P值均 < 0.05);以地区进行分层分析后显示, 各地区的青少年自伤行为的影响因素不全相同。结论独生子女、主要照料人文化程度等家庭因素可能与青少年自伤行为发生有关, 青少年自伤行为的家庭影响存在地区差异。
- 自我伤害行为 /
- 家庭 /
- 精神卫生 /
- 青少年 /
- 回归分析
Abstract: Objective To analyze household determinants of adolescents'non-suicidal self-injury (NSSI), and to provide scientific basis for NSSI intervention amogn adolescents. Methods Using stratified random cluster sampling method, 15 623 middle school students aged 11-20 were selected from Heilongjiang, Anhui, Hubei, Yunnan, and Guangdong provinces, and non-suicidal self-injury and related household determinants were investigated by questionnaire. Results The survey showed that 28.8% of people who had NSSI in the past year accounted; among them, 17.6% had 1-4 times (occasional self-injury) and 11.2% had 5 times or more (repeated self-injury) univariate results showed that whether they were an only child, family type, educational level of the main caregiver, family rearing style, family monthly income per capita, and whether there was a family history of mental illness was associated with adolescents'NSSI (χ²=6.30-12.16, P < 0.05);multivariate Logistic regression analysis showed that whether one child or family parenting style is still significantly related to occasional NSSI (OR=1.11, 1.34, P < 0.05) after controlling for gender, age, grade, ethnicity, emotional control, resilience, loneliness and social support; whether it is an only child, educational level of the main caregiver and family parenting style are still significantly related to repeated NSSI (OR=1.19, 0.69, 1.57, P < 0.05);stratified analysis by region shows that the influencing factors of NSSI in adolescents in each region are different. Conclusion Family factors such as the only child and the education level of the main caregiver may be related to the occurrence of adolescents'NSSI, but there are regional differences in the family impact of NSSI.
- Self-injurious behavior /
- Family /
- Mental health /
- Adolescent /
- Regression analysis
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表 1 不同人口学特征青少年NSSI的报告率比较

Table 1. NSSI report of adolescents with different demographic characteristics

人口统计学指标	人数	偶有	反复	χ²值	P值
性别
男	7 980	1 287(16.1)	908(11.4)	14.63	< 0.01
女	7 525	1 375(18.3)	889(11.8)
年龄/岁
11~14	6 190	1 112(18.0)	767(12.4)	13.84	0.01
15~17	7 696	1 271(16.5)	857(11.1)
18~20	1 619	279(17.2)	173(10.7)
学段
初中	8 267	1 398(16.9)	1 007(12.2)	6.30	0.04
高中	7 238	1 264(17.5)	790(10.9)
民族
汉族	14 050	2 455(17.5)	1 537(10.9)	65.24	< 0.01
少数民族	1 455	207(14.2)	260(17.9)
是否独生子女
是	5 377	855(15.9)	567(10.5)	21.64	< 0.01
否	10 128	1 807(17.8)	1 230(12.1)
家庭类型
核心家庭、大家庭或联合家庭	13 965	2 401(17.2)	1 563(11.2)	25.60	< 0.01
单亲家庭	760	115(15.1)	115(15.1)
重组家庭或隔代家庭	780	146(18.7)	119(15.3)
主要照料人文化程度
初中及以下	10 889	1 889(17.3)	1 218(11.2)	10.15	0.04
高中或中专	3 553	612(17.2)	432(12.2)
大学及以上	1 063	161(15.1)	147(13.8)
家庭教养方式^*
严格	4 691	773(16.5)	548(11.7)	102.16	< 0.01
溺爱	555	102(18.4)	74(13.3)
放任/粗暴/变化无常	1 672	358(21.4)	284(17.0)
民主	7 990	1 326(16.7)	831(10.4)
家庭人均收入水平/元^*
< 1 000	1 997	348(17.4)	281(14.1)	18.67	< 0.01
1 000~5 999	10 760	1 873(17.3)	1 201(11.0)
≥6 000	2 064	336(16.3)	256(12.4)
精神疾病家庭史^*
是	631	125(19.8)	112(17.7)	31.93	< 0.01
否	13 933	2 383(17.1)	1 582(11.4)
注：()内数字为报告率/%；*表示数据有缺失值。

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表 2 青少年NSSI家庭相关因素多分类Logistic回归分析(n=15 505)

Table 2. Multivariate Logistic regression analysis of family-related factors in adolescents with NSSI(n=15 505)

自变量	选项	偶有NSSI			反复NSSI
自变量	选项	β值	Wald χ²值	OR值(OR值95%CI)	β值	Wald χ²值	OR值(OR值95%CI)
是否独生子女	是	0.11	4.85	1.11(1.01~1.22)^*	0.17	8.22	1.19(1.06~1.33)^*
主要照料人文化程度	高中或中专				-0.37	12.31	0.69(0.57~0.85)^*
	大学及以上				-0.19	2.86	0.83(0.66~1.03)
家庭教养方式	溺爱	0.03	0.05	1.03(0.81~1.29)	0.17	1.21	1.19(0.88~1.61)
	放任/粗暴/变化无常	0.10	0.42	1.11(0.81~1.52)	0.26	1.64	1.29(0.87~1.91)
	民主	0.29	5.17	1.34(1.04~1.72)^*	0.45	7.57	1.57(1.14~2.16)^*
注：*P < 0.05；是否独生子女以否为参照，主要照料人文化程度以初中及以下为参照，家庭教养方式以严格为参照。

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参考文献(21)

[1]	TSCHAN T, SCHMID M, IN-ALBON T. Parenting behavior in families of female adolescents with nonsuicidal self-injury in comparison to a clinical and a nonclinical control group[J]. Child Adolesc Psych Ment Health, 2015, 9: 17. doi: 10.1186/s13034-015-0051-x
[2]	LIU Z, HUA C, BO Q, et al. Psychological and behavioral characteristics of suicide attempts and non-suicidal self-injury in Chinese adolescents[J]. J Affect Disord, 2018, 226: 287-293. doi: 10.1016/j.jad.2017.10.010
[3]	MORAN P, COFFEY C, ROMANIUK H, et al. The natural history of self-harm from adolescence to young adulthood: a population-based cohort study[J]. Lancet, 2012, 379(9812): 236-243. doi: 10.1016/S0140-6736(11)61141-0
[4]	薛艳丽. 家庭环境因素对学龄前儿童心理行为发育影响[J]. 世界最新医学信息文摘, 2016, 16(55): 57-58. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201655035.htm XUE Y L. The influence of family environment factors on the development of preschool children's psychological behavior[J]. World Latest Med Inform, 2016, 16(55): 57-58. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201655035.htm
[5]	TANG J, MA Y, LEWIS S P, et al. Association of Internet addiction with nonsuicidal self-injury among adolescents in China[J]. JAMA Netw Open, 2020, 3(6): e206863. doi: 10.1001/jamanetworkopen.2020.6863
[6]	马颖, 陈雁如, 张曼. 青少年非自杀性自伤行为和网络成瘾的相关性[J]. 中国学校卫生, 2019, 40(7): 972-976. doi: 10.16835/j.cnki.1000-9817.2019.07.004 MA Y, CHEN Y R, ZHANG M. Association of non-suicidal self-injurious with Internet addictive behavior among adolescents[J]. Chin J Sch Health, 2019, 40(7): 972-976. doi: 10.16835/j.cnki.1000-9817.2019.07.004
[7]	TANG J, YANG W, AHMED N, et al. Stressful life events as a predictor for nonsuicidal self-injury in Southern Chinese adolescence: a cross-sectional study[J]. Medicine, 2016, 95(9): e2637. doi: 10.1097/MD.0000000000002637
[8]	MCGUIKE A. Diagnosing the diagnostic and statistical manual of mental disorders: fifth edition[M]. Abingdon: Taylor and Francis, 2018.
[9]	IN-ALBON T, BVRLI M, RUF C, et al. Non-suicidal self-injury and emotion regulation: a review on facial emotion recognition and facial mimicry[J]. Child Adolesc Psych Ment Health, 2013, 7(1): 5. doi: 10.1186/1753-2000-7-5
[10]	唐杰. 培养青少年情绪管理能力预防自我伤害行为[J]. 中国学校卫生, 2019, 40(7): 964-967, 976. doi: 10.16835/j.cnki.1000-9817.2019.07.002 TANG J. Emotional regulation and self-injury behavior among adolescents[J]. Chin J Sch Health, 2019, 40(7): 964-967, 976. doi: 10.16835/j.cnki.1000-9817.2019.07.002
[11]	TANG J, MA Y, GUO Y, et al. Association of aggression and non-suicidal self injury: a school-based sample of adolescents[J]. PLoS One, 2013, 8(10): e78149. doi: 10.1371/journal.pone.0078149
[12]	胡月琴, 甘怡群. 青少年心理韧性量表的编制和效度验证[J]. 心理学报, 2008(8): 902-912. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXB200808005.htm HU Y Q, GAN Y Q. Development and validity of adolescent metal toughness scale[J]. Acta Psychol Sin, 2008(8): 902-912. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXB200808005.htm
[13]	李晓巍, 邹泓, 刘艳. 孤独感量表在中学生群体中的初步修订[J]. 中国临床心理学杂志, 2014, 22(4): 731-733, 760. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201404037.htm LI X W, ZOU H, LIU Y. Psychometric evaluation of loneliness scale in Chinese middle school students[J]. Chin J Clin Psychol, 2014, 22(4): 731-733, 760. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201404037.htm
[14]	叶悦妹, 戴晓阳. 大学生社会支持评定量表的编制[J]. 中国临床心理学杂志, 2008, 16(5): 456-458. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY200805005.htm YE Y M, DAI X Y. Development of social support scale for university students[J]. Chin J Clin Psychol, 2008, 16(5): 456-458. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY200805005.htm
[15]	张家鑫. 家庭功能与特殊家庭青少年自伤的关系: 基于情绪管理模型[D]. 长沙: 湖南师范大学, 2016. ZHANG J X. Family function and special family teenagers self-injury behavior: based on emotion management model[D]. Changsha: Hunan Normal University, 2016.
[16]	SWANNELL S V, MARTIN G E, PAGE A, et al. Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, Meta-analysis and Meta-regression[J]. Suicid Life Threat Behav, 2014, 44(3): 273-303. doi: 10.1111/sltb.12070
[17]	王玉龙, 袁燕, 张家鑫. 消极情绪与留守青少年自伤: 家庭功能与情绪表达的调节作用[J]. 中国临床心理学杂志, 2017, 25(1): 75-78, 81. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201701017.htm WANG Y L, YUAN Y, ZHANG J X. Negative emotions and self-injury in left-behind adolescents: moderating effect of family functioning and emotional expression[J]. Chin J Clin Psychol, 2017, 25(1): 75-78, 81. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201701017.htm
[18]	ZHANG S, TAO F, WU X, et al. Low health literacy and psychological symptoms potentially increase the risks of non-suicidal self-injury in Chinese middle school students[J]. BMC Psychiatry, 2016, 16(1): 327. doi: 10.1186/s12888-016-1035-y
[19]	LIU C, MUNAKATA T, FUJIYAMA K, et al. Mental health and psychosocial factors with single-child high school students in an urban city of China[J]. Nihon Koshu Eisei Zasshi, 2003, 50(1): 15-26.
[20]	HAWTON K, HALL S, SIMKIN S, et al. Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990-2000[J]. J Child Psychol Psychiatry, 2003, 44(8): 1191-1198. doi: 10.1111/1469-7610.00200
[21]	REMES H, MOUSTGAARD H, KESTILA L M, et al. Parental education and adolescent health problems due to violence, self-harm and substance use: what is the role of parental health problems?[J]. J Epidemiol Comm Health, 2019, 73(3): 225-231.