Association between Non-Suicidal Self-Injuries and Suicide Attempts in Chinese Adolescents and College Students: A Cross-Section Study

Abstract

PurposeThis study examined the association between non-suicidal self-injury (NSSI) and suicide attempts among Chinese adolescents and college students.MethodsA total sample of 2013 Chinese students were randomly selected from five schools in Wuhan, China, including 1101 boys and 912 girls with the age ranging between 10 and 24 years. NSSI, suicidal ideation, suicide attempts and depressive symptoms were measured by self-rated questionnaires. Self-reported suicide attempts were regressed on suicidal ideation and NSSI, controlling for participants' depressive symptoms, and demographic characteristics.ResultsThe self-reported prevalence rates of NSSI, suicidal ideation, suicide attempts were 15.5%, 8.8%, and 3.5%, respectively. Logistic regression analyses indicated that NSSI was significantly associated with self-reported suicide attempts. Analyses examining the conditional association of NSSI and suicidal ideation with self-reported suicide attempts revealed that NSSI was significantly associated with greater risk of suicide attempts in those not reporting suicidal ideation than those reporting suicidal ideation in the past year.ConclusionsThese findings highlight the importance of NSSI as a potentially independent risk factor for suicide attempts among Chinese/Han adolescents and college students.

Childhood Adversity, Recent Life Stressors and Suicidal Behavior in Chinese College Students

“…This observation is consistent with the conclusion of a previous study on Chinese college students [16], and also in high concordance with many reports internationally [17][18][19]. As for the effect of region, there was no significant rural-urban difference for suicidal ideation, but the risk of suicide attempt was significantly higher among students coming from urban areas than those from rural China.…”

Prevalence of suicide attempts among Chinese adolescents: A meta-analysis of cross-sectional studies

“…Of these studies, 11 studies [16][17][18][19][20][23][24][25][26][27][28] were from PubMed and Embase, while the other 32 studies [21,22,58] published in Chinese were from Wanfang Data, Chongqing VIP and Chinese National Knowledge Infrastructure (CNKI). Among these studies, we removed 63 duplicate studies.…”

Meta-analysis of risk factors for nonsuicidal self-injury

“…These findings suggest that certain factors may act as risk factors for both suicidal and nonsuicidal thoughts and behaviors. This is especially important given the high overlap between these thoughts and behaviors (e.g., Lloyd-Richardson et al, 2007; Tang et al, 2011; Brunner et al, 2007; MacLaren & Best, 2010). Future research disentangling whether this overlap occurs simply because NSSI is predictive of future suicidal behaviors (e.g., does hopelessness predict suicidal thoughts and behaviors when controlling for a history of NSSI?)…”

“…This is an especially important risk factor to examine in conjunction with other factors to help discern the unique importance of a given factor above and beyond a history of these behaviors. Moreover, a large body of research has demonstrated that NSSI and suicidal thoughts and behaviors are highly comorbid (e.g., Lloyd-Richardson, Perrine, Dierker, & Kelley, 2007; Tang et al, 2011; Brunner et al, 2007; MacLaren & Best, 2010). Extending upon research examining NSSI as a risk factor for future suicidal behaviors, researchers have also examined whether these thoughts and behaviors are predictive of future NSSI.…”