The association between non-suicidal self-injury and negative life events in children and adolescents in underdeveloped regions of south-western China

Abstract

Background The association between negative life events and Non-suicidal self-injury (NSSI) in children and adolescents has been extensively discussed. Nevertheless, little is known about the relationship between negative life events and repetition and severity of NSSI. This survey aims to understand the association between NSSI prevalence, severity, repetition and the negative life events in children and adolescents in underdeveloped regions in south-western China. Methods In this population-based cross-sectional study, 3,146 children and adolescents were included from underdeveloped regions of south-western China, and each of them requested to complete a self-assessment questionnaire. The Modified Version of Adolescents Self-Harm Scale (MASHS) and the Adolescent Self-rating negative Life Events Check-list were used to evaluate NSSI behaviors and negative life events, respectively. The statistical implementation of this study was carried out in the R statistical software, and the logistic regression analysis method was used to analyze the relationship between negative life events and adolescents’ non-suicidal self-injury behaviors. Results The average age of all included participants was 13.31 years old. The lifetime prevalence of NSSI was 47.0% (95% CI [36.3–58.0%]). Gender, grade level and ASLEC was positively associated with NSSI. Further analysis revealed that, for all five dimensions of ASLEC, only interpersonal relationship factor (IRF) (OR 1.77 (95% CI [1.06–2.97])), health adaptation factor (HAF) (OR 2.08 (95% CI [1.31–3.31])) showed prominent association with NSSI. Multivariate Logistic regression models revealed that, repetitive NSSI (OR 4.54 (95% CI [3.66–5.63])) and NSSI severity (OR 9.01 (95% CI [6.11–13.29])) were positively associated with ASLEC. Conclusion NSSI is very common among children and adolescents in underdeveloped regions of south-western China. Negative life event are positively associated with NSSI, repeated NSSI, and severe NSSI. Negative life events centered intervention measures might be effective in reducing NSSI among school children and adolescents in underdeveloped regions of south-western China.

The Relationship Between Negative Life Events and Nonsuicidal Self-Injury Among Chinese Adolescents: A Moderated-Mediation Model

“… 9 The high prevalence of NSSI seriously endangers the physical and mental health of adolescents and has a huge social burden, which has attracted the attention of researchers. A large number of studies on adolescent NSSI have been published in recent years, and although it has been established that NSSI is associated with complex psychosocial factors, such as anxiety, depression, child abuse, autism, and negative life events, 5 , 10 , 11 there is no unified explanation for the occurrence of NSSI. Negative life events refer to changes in individuals’ family, work, and/or study environments that may cause negative psychological and physiological outcomes.…”

“…Cross-sectional studies of Chinese and Italian adolescents with NSSI consistently support a positive association between negative life events and adolescent NSSI. 11 , 14 A recent cohort study of community-based adolescents assessed distal risk factors at baseline, proximal risk factors for NSSI such as negative life events after 2 years of follow-up, and changes in adolescents’ NSSI at the end of 2.5 years of follow-up, with the result that adolescents with NSSI behaviors experienced more negative life events than those without NSSI behaviors. 15 Another multiwave longitudinal study measuring the association between NSSI and negative life events at baseline, 6 months postbaseline, and 9 months postbaseline showed that those who reported NSSI during the nine-month follow-up period had higher mean rates of negative life events.…”

Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis

“…This result suggests that the relationship between peer victimization and NSSI depends on environmental factors [ 94 ]. Compared with the family environment, campus interpersonal relationships may play a more critical role in students’ emotional, cognitive, and personality development [ 95 ]. Some studies report that some teenagers use NSSI to regulate interpersonal relationships and control others [ 96 ].…”

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

“…According to the construction of ASLEC, interpersonal relationships include "being misunderstood, discrimination, quarrelling with classmates and friends, and losing face in public. " Interpersonal relationships during school have important influence on students' cognitive, emotional, and personality development, and may even exceed family influence (61). Poor interpersonal relationships can lead to mental health problems in adolescents (58).…”