Association between life events, anxiety, depression and non-suicidal self-injury behavior in Chinese psychiatric adolescent inpatients: a cross-sectional study

Abstract

BackgroundNon-suicidal self-injury (NSSI) is a major public health concern among adolescents. Further research is needed into contributors to this behavior, in particular among adolescents with psychiatric disorders. The aim of the present study was to explore the impact of life events and emotional stress on NSSI among hospitalized psychiatric adolescents.MethodsIn this cross-sectional study, 505 Chinese psychiatric adolescent inpatients 10–19 years old completed questionnaires about sociodemographic characteristics and NSSI as well as the Adolescent Self-Rating Life Events Checklist (ASLEC), the State–Trait Anxiety Inventory Form Y, and the Center for Epidemiological Studies Depression Scale. Chi-square test was used to compare the incidence of NSSI in psychiatric adolescent patients with different sociodemographic. T-test was used to compare the total scores and dimension scores of the ASLEC, STAI-Y, and CES-D between the NSSI group and the non-NSSI group. A binary logistic regression model was built to explore the relationships among sociodemographic characteristics, questionnaire scores and NSSI.ResultsMost psychiatric adolescent inpatients (393, 77.8%) reported NSSI behavior. The higher risk for NSSI was observed among female (odds ratio [OR] 2.665, 95% confidence interval [CI] 1.575–4.510), younger adolescents (10–14 years; OR 2.021, 95% CI 1.258–3.245), with a suicide history (OR 2.479, 95% CI 1.549–3.967), or with depression symptom (OR 3.217, 95% CI 1.572–6.582) and those with higher scores of ASLEC (OR 1.019, 95% CI 1.010–1.029).ConclusionOur study in China is one of the first to apply to adolescent inpatients the diagnostic criteria of NSSI in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders. Our analysis suggests that NSSI prevalence is disturbingly high among adolescents with mental illness in China. A better understanding of contributing factors, especially negative life events and negative emotions, may guide interventions that can reduce its prevalence.

The Effect of Bullying Victimization on Adolescent Non-Suicidal Self-Injury: The Mediating Roles of Alexithymia and Self-Esteem

“…Of the 1299 participants, there were 607 (46.7%) males and 692 (53.3%) females aged 12-18 years old (mean: 15.33±1.51 years). At the time of data collection, there were 566 (45.1%) junior middle school students (grades 7, 8, 9), and 733 (54.9%) high middle school students (grades 10,11,12). The results of the Chi-square test showed high middle school students were more inclined to be involved in NSSI than participants of junior middle school (p = 0.03).…”

“…There have been reports of higher rates among psychiatric adolescent inpatients, which exceed 40%. [9][10][11] Non-suicidal self-injury seriously affects the physical and mental health of adolescents as it is associated with greater psychosocial functioning impairment, 12 higher levels of depression and anxiety, 13 impulsivity, 14 and suicide attempts. 15 Due to rapid physiological and psychological changes, adolescents are most intensely influenced by negative peer relationships.…”

Understanding Comorbidity Between Non-Suicidal Self-Injury and Depressive Symptoms in a Clinical Sample of Adolescents: A Network Analysis

“…The detection rate of depression among NSSI patients was as high as 81.3%. 18 It has been reported that compared to simple depression, comorbidity will characterize more severe clinical phenotypes in adolescents, aggravate the psychological and disease burden of patients, and increase the risk of suicide. 19 Previous research on comorbidity of NSSI and depression in adolescents had focused on correlates, such as introversion, intermediate defenses, 20 youthfulness, and impulsivity, 21 but the specific symptoms underlying this correlation are still unclear.…”

Effect of Acceptance and Commitment Therapy on Emotion Regulation in Adolescent Patients with Nonsuicidal Self-Injury

“… 1 NSSI is common in adolescents, usually in mid-adolescence (about 14-16 years old), 2 and manifests as scratching the skin, cutting the wrist, pulling the hair, banging the head, and scalding. 3 Adolescent NSSI behavior is a worldwide concern, and its incidence varies widely among different countries and regions. Indeed, it has become a social public-health problem affecting the mental health of adolescents.…”