Stressful life events and non-suicidal self-injury among Chinese adolescents: A moderated mediation model of depression and resilience

Chang, Wei Pin; Li, Zhiyong; Ma, Tao; Jiang, Xiaxia; Yu, Chengfu; Xu, Qian

doi:10.3389/fpubh.2022.944726

Cited by 15 publications

(17 citation statements)

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“…Especially, a set of constructs i.e., PMH, emotional stability, conscientiousness, optimism, resilience, and coping flexibility negatively predicted suicidal ideations and suicidal attempts, which state people’s positive attitudes and perceptions of adversity that could have a significant impact on their suicidal behaviours in dealing with daily life stresses. These observations complement the existing literature, which has established that a higher level of these positive sociopsychological constructs would predict a lower risk of suicidal ideations among university students and adolescents (Brailovskaia et al, 2020; Kato, 2022; Kumar et al, 2022; Lawson et al, 2022; Vidal-Arenas V et al, 2022; Wei et al, 2022). Furthermore, current surveys' findings regarding suicidal attempts also supplement an existing reservoir of evidence about the detrimental predictive roles of substantial positive sociopsychological constructs.…”

Section: Discussionsupporting

confidence: 85%

“…Several research gaps have been identified based on investigations of the existing literature. First, there seemed to be a dearth of studies on medical students (Seo et al, 2022), even though much research concentrated on other university students (Kim and Cha, 2018; Siegmann et al, 2018; Song and Bae, 2022) or adolescents (Wei et al, 2022) or clinical populations (Kessler et al, 2019; Siegmann et al, 2019). Second, the existing literature is mainly conducted in Western (Kessler et al, 2019; Siegmann et al, 2019; Sher, 2019; Brailovskaia et al, 2020; Teismann and Brailovskaia et al, 2020; Seo et al, 2022) or Eastern cultures (Bae and Lee, 2018; Kim and Cha, 2018; Song and Bae, 2022), whereas no such data are available in Indian cultures with different characteristics such as lesser individualistic and self-centered, and more collectivistic, which might have impacted the suicidal resilience differently than more self-focused Western cultures.…”

Section: The Present Studymentioning

confidence: 99%

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A Moderation Model for Bolstering Resilience to Suicidal Psychopathology

Garg,

Kharb

2024

J Nerv Ment Dis

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Positive sociopsychological constructs and coping flexibility may be helpful for alleviating suicidal psychopathology, although relatively little research has examined this possibility among medical students. This survey aimed to investigate whether positive sociopsychological constructs and coping flexibility could buffer the negative impact of daily life stress and bolster the resilience to suicidal ideations and attempts among medical students. This cross-sectional model was based on a study of 787 Indian medical students (725 women and 62 men; mean age, 21.08 years; SD = 2.78; range, 19–37 years) who were asked to complete a battery of self-administered questionnaires. For the purpose of determining the independent and interaction impacts of potential variables of influence, hierarchical multiple linear regression models were used. The moderation analysis investigated that the association between daily life stress and suicidal ideation was buffered among the students having higher levels of positive mental health and coping flexibility, whereas this association was no longer significant at the highest level of positive mental health. Furthermore, the relationship between daily life stress and suicidal attempts continued to be buffered by above-average levels of coping flexibility, emotional stability (ES), and optimism. These findings represent that promoting positive mental health, coping flexibility, ES, and optimism may be a promising approach to mitigate suicidal thoughts and attempts in interventions for medical students at high risk. These modifiable moderating factors can be enhanced by empirically supported treatment and prevention efforts to bolster suicidal resilience.

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Section: Discussionsupporting

confidence: 85%

Section: The Present Studymentioning

confidence: 99%

A Moderation Model for Bolstering Resilience to Suicidal Psychopathology

Garg,

Kharb

2024

J Nerv Ment Dis

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“…This mediated model with moderation suggests a possible therapeutic option. Resilience is defined as an individual’s ability to proactively adapt to their environment in the face of adversity, and it is comprised of two key conditions: exposure to significant adversity (e.g., exposure to community violence, parental mental illness, and poverty) and positive adaptation (good academic performance, positive relationships with teachers or peers)[ 82 ]. The Protective Resilience Model proposes that social support and loneliness can be effectively mediated through the agency of personal resilience, enabling individuals to have a better quality of life [ 83 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between alexithymia, loneliness, resilience and non-suicidal self-injury in adolescents with depression: a multi-center study

Zhang

Sun

et al. 2023

BMC Psychiatry

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Objective Non-suicidal self-injury (NSSI) behaviors are prevalent in adolescents and have adverse effects on physical and mental health. However, little is known about the relationship between NSSI and alexithymia, or the underlying mechanisms that could explain this relationship. This study aimed to elucidate the current status of NSSI in adolescent depression, and analyze the relationship between alexithymia, loneliness, resilience, and adolescent depression with NSSI, so as to provide a theoretical basis for psychotherapeutic interventions. Method The study sample involved inpatients and outpatients from 12 hospitals across China and adolescents with depression who met the DSM-5 diagnostic criteria for depression episode. The following scales were used: The Functional Assessment of Self-Mutilation, Toronto Alexithymia Scale, UCLA Loneliness Scale, and Connor Davidson Resilience Scale. Results The detection rate of NSSI in adolescents with depression from 2021.01.01-2022.01.01 was 76.06% (1782/2343). Spearman’s correlation analysis revealed a significant correlation between alexithymia, loneliness, resilience and NSSI in depressed adolescents, and the results of the non-parametric test showed that the differences between the two groups for each factor were statistically significant. Binary logistic regression results showed that alexithymia (B = 0.023, p = 0.003, OR = 1.023, 95% CI: 1.008–1.038) and depression (B = 0.045, p < 0.001, OR = 1.046, 95% CI: 1.026–1.066) are risk factors for NSSI, resilience (B = − 0.052, p < 0.001, OR = 0.949, 95% CI: 0.935 − 0.964) is a protective factor for NSSI. Alexithymia directly predicted NSSI and also indirectly influenced NSSI through the mediated effect of resilience. Loneliness moderates the first half of the path of this mediated model. Conclusion The present study confirms a moderated mediation effect: Alexithymia can have an impact on NSSI behaviors in depressed adolescents through the mediating role of resilience. Loneliness, as a moderating variable, moderated the first half of the pathway of the mediating model. We discuss perspectives for future research and interventions based on the findings of the study.

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“…When a negative life event occurs, timely understanding of the child's psychological state and effective communication can effectively reduce the impact of the event on the child's psychological state and prevent the development of anxiety and depression. At the same time, it is important to develop resilience in the face of adversity in children's lives, as previous research [ 18 ] has shown that enhancing “resilience” can effectively buffer the link between negative life events and adverse outcomes in adolescents. The most effective way to address anxiety and depression in adolescents is to bring them to a medical professional in a timely manner, both to reduce the impact of negative life events on NSSI in a mediated way and to reduce the impact of emotional symptoms on NSSI directly.…”

Section: Discussionmentioning

confidence: 99%

“…[ 17 ]. A previous survey of Chinese adolescents showed that depression can act as a mediator between stressful life events and the occurrence of NSSI [ 18 ]. In addition, other studies have also shown that anxiety and depression are risk factors for NSSI [ 19 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

The relationship between negative life events and non-suicidal self-injury (NSSI) among Chinese junior high school students: the mediating role of emotions

et al. 2022

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Background Adolescent non-suicidal self-injury (NSSI) is common and adolescence is the most common period of first self-injury, and the occurrence of NSSI is influenced by negative life events and emotional symptoms. The mediating role of emotional symptoms in the interaction between negative life events and NSSI has not been carefully investigated yet. Methods For middle school students in three schools in a Chinese province, the Adolescents Self-Harm Scale was used to investigate NSSI, the Adolescent Self-Rating Life Events Check List was used to investigate adolescent negative life events, and the Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to assess their emotional symptoms. After the description of general data and the test for differences between groups, the relationship between negative life events, emotional symptoms and NSSI was analyzed using Pearson correlation analysis. Structural equation modeling was used to analyze the mediating role of emotions in negative life events and NSSI. Results A total of 2376 junior high school students completed this survey, which revealed an annual NSSI prevalence of 37.1% (n = 881) and a higher prevalence of NSSI among girls and rural adolescents. Among adolescents who developed NSSI, 67.4% (N = 594) used multiple means of self-injury. The most common means of self-injury was hair pulling (51.0%), and the most common NSSI purpose and external factors/events were venting bad emotions or feelings (57.5%) and poor academic performance (44.9%), respectively. Negative life events, emotional symptoms and NSSI were positively associated (P < 0.05). Structural equation modeling with negative life events, emotional symptoms and NSSI as variables showed that the model-fit index matched the data well, with RMSEA = 0.073, AGFI = 0.945, GFI = 0.980, CFI = 0.985, NFI = 0.982, TLI = 0.968, IFI = 0.985, and negative life events, emotional symptoms (anxiety, depression) and NSSI all had direct effects with standardized path coefficients of 0.16, 0.19, and 0.23, respectively, with negative life events playing an indirect role in NSSI through emotional symptoms and emotional symptoms playing an incomplete mediating role in negative life events and NSSI. Conclusion The prevalence of NSSI was higher among Chinese junior high school students. Both negative life events and emotional symptoms were direct risk factors for NSSI. In addition, negative life events were also indirect risk factors for NSSI, and emotional symptoms played an incomplete mediating role in the relationship between the effects of negative life events and NSSI. This indicates that the combination of reducing the frequency of negative life events while maintaining individual emotional stability during adolescent development can effectively reduce the prevalence of NSSI in adolescents.

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Stressful life events and non-suicidal self-injury among Chinese adolescents: A moderated mediation model of depression and resilience

Cited by 15 publications

References 50 publications

A Moderation Model for Bolstering Resilience to Suicidal Psychopathology

A Moderation Model for Bolstering Resilience to Suicidal Psychopathology

Relationship between alexithymia, loneliness, resilience and non-suicidal self-injury in adolescents with depression: a multi-center study

The relationship between negative life events and non-suicidal self-injury (NSSI) among Chinese junior high school students: the mediating role of emotions

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