Study on influencing factors of non-suicidal self-injury behavior and the link with suicide among youth
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摘要:
目的 探讨安徽省合肥市青少年群体非自杀性自伤(non-suicidal self-injury, NSSI)行为的影响因素及其与自杀的相关性。 方法 随机选取合肥市初中生和高中生共10 400名进行问卷调查。并用SPSS 22.0统计分析软件对数据进行分析，比较不同特征中学生NSSI行为检出率差异，以及探索NSSI行为的影响因素。 结果 不同年级、居住地、家庭经济情况、教养方式、父母关系、睡眠质量、兴趣以及有无自杀意念、自杀企图、自杀行为、抑郁情绪的中学生存在NSSI行为检出率差异(均有P < 0.05)；社会支持、依恋质量好的个体有更少的NSSI行为(均有P < 0.05)；居住于城镇、对他人丧失兴趣、以及重度抑郁是NSSI行为的危险因素(均有P < 0.05)，高质量的睡眠质量、亲子依恋、同伴依恋及社会支持是NSSI行为的保护因素(均有P < 0.05)。 结论 NSSI行为的发生受多种因素影响。家庭和社会应从青少年人际关系的角度出发，为中学生创造安全和谐的环境，以减少其NSSI行为。 Abstract:Objective To explore influencing factors of non-suicidal self-injury (NSSI) and the link with suicide among middle students in Hefei City, Anhui Province. Methods Designed questionnaires were delivered to 10 400 middle students. The detection rate of NSSI on different demographic and the influencing factors were analyzed by SPSS 22.0 software. Results The difference of detection rate on grades, location, family economic status, sleep quality, interest, suicide ideation, suicide attempt, suicide behaviors and depression were statistically significant (all P < 0.05). Students with high level of social support and attachment had lower frequency of NSSI (all P < 0.05). Located in town, loss interest of others, severe depression were risk factors of NSSI (all P < 0.05). Good attachment with parents and friends, high sleep quality and social support were protective factors of NSSI (all P < 0.05). Conclusions NSSI influenced by multiple factors. To reduce NSSI behaviors, family, society should create safe and harmonious environment for middle school students in order to reduce NSSI. -
Key words:
- Non-suicidal self-injury /
- Attachment /
- Social support /
- Depression
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表 1 2019年合肥不同特征中学生NSSI行为检出率比较[n(%)]
Table 1. Differences in NSSI behavior detection rate among middle school students with different demographic characteristics in Hefei in 2019 [n(%)]
变量 总人数 无NSSI行为 偶发NSSI行为 反复NSSI行为 χ2值 P值 性别 1.472 0.479 男 4 626(53.29) 2 392(27.56) 694(7.99) 1 540(17.74) 女 4 054(46.71) 2 048(23.60) 609(7.02) 1 397(16.09) 年级 15.933 0.014 初一 908(10.46) 471(5.43) 126(1.45) 311(3.58) 初二 1 085(12.50) 531(6.12) 204(2.35) 350(4.03) 高一 3 430(39.52) 1 787(20.59) 484(5.58) 1 159(13.35) 高二 3 257(37.52) 1 651(19.02) 489(5.63) 1 117(12.87) 居住地 17.656 < 0.001 城镇 6 490(74.76) 3 299(38.01) 982(11.31) 2 269(26.14) 农村 2 190(25.24) 1 201(13.84) 321(3.70) 668(7.70) 是否独生 0.859 0.651 是 2 681(30.89) 1 356(15.62) 399(4.60) 926(10.67) 否 5 999(69.11) 3 084(35.53) 904(10.41) 2 011(23.17) 教养方式 1.221 < 0.001 民主型 6 145(70.79) 3 339(38.47) 927(10.68) 1 879(21.64) 专制型 1 265(14.57) 507(5.84) 188(2.16) 570(6.57) 溺爱型 168(1.94) 77(0.89) 23(0.27) 68(0.78) 放任型 1 102(12.70) 517(5.96) 165(1.90) 420(4.84) 家庭经济 34.633 < 0.001 很困难 200(2.30) 95(1.09) 24(0.28) 81(0.93) 比较困难 995(11.46) 450(5.18) 179(2.06) 366(4.22) 一般 6 394(73.66) 3 372(38.85) 931(10.73) 2 091(24.08) 比较好 995(11.46) 477(5.50) 160(1.84) 358(4.12) 很好 96(1.12) 46(0.53) 9(0.11) 41(0.48) 父母关系 2.312 < 0.001 和睦 5 868(67.60) 3 296(37.97) 847(9.76) 1 725(19.87) 一般 2 347(27.04) 1 001(11.53) 387(4.46) 959(11.05) 不好 465(5.36) 143(1.65) 69(0.79) 253(2.92) 好友个数(个) 1.965 < 0.001 0 269(3.10) 79(0.91) 36(0.41) 154(1.78) 1~3 2 055(23.67) 853(9.83) 337(3.88) 865(9.96) >3 6 356(73.23) 3 508(40.41) 930(10.72) 1 918(22.10) 自杀意念 1.354 < 0.001 有 2 720(31.34) 675(7.78) 406(4.68) 1 639(18.88) 无 5 960(68.66) 3 765(43.38) 897(10.33) 1 298(14.95) 自杀企图 5.875 < 0.001 有 778(8.96) 122(1.41) 94(1.08) 562(6.47) 无 7 902(91.04) 4 319(49.76) 1 210(13.94) 2 373(27.34) 自杀行为 5.797 < 0.001 有 720(8.29) 106(1.22) 83(0.96) 531(6.12) 无 7 960(91.71) 4 334(49.93) 1 220(14.05) 2 406(27.72) 兴趣 5.828 < 0.001 未失去 3 999(46.07) 2 508(28.89) 543(6.26) 948(10.92) 减少 3 587(41.33) 1 620(18.66) 609(7.02) 1 358(15.65) 大多失去 942(10.85) 257(2.96) 138(1.59) 547(6.30) 全部失去 152(1.75) 55(0.63) 13(0.15) 84(0.97) 睡眠质量 5.873 < 0.001 很好 1 083(12.48) 768(8.85) 136(1.57) 179(2.06) 比较好 2 577(29.69) 1 551(17.87) 383(4.42) 643(7.40) 一般 4 158(47.90) 1858 (21.40) 684(7.88) 1 616(18.62) 比较差 709(8.17) 215(2.48) 86(0.99) 408(4.70) 很差 153(1.76) 45(0.52) 14(0.16) 94(1.08) 抑郁 1.285 < 0.001 无 5 278(60.81) 3 374(38.87) 797(9.18) 1 107(12.75) 轻度 2 306(26.57) 854(9.84) 378(4.36) 1 074(12.37) 中度 883(10.17) 195(2.25) 113(1.30) 575(6.62) 重度 213(2.45) 17(0.20) 15(0.17) 181(2.08) 
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表 2 2019年合肥中学生各NSSI行为组的抑郁、依恋、社会支持及其各因子得分比较(x±s)
Table 2. Difference in score of depression, attachment, social support and their factors among three NSSI behavior groups among middle school students in Hefei in 2019 (x±s)
变量 无NSSI行为 偶发NSSI行为 反复NSSI行为 F值 P值 社会支持 主观支持 19.83±4.56 18.68±4.66 16.98 ±5.28 309.179 < 0.001 客观支持 25.72±4.57 24.41±4.89 22.31±5.82 397.723 < 0.001 支持利用度 22.55±6.03 21.07±5.95 18.71±6.55 339.009 < 0.001 支持总分 68.11±13.06 64.18±13.04 58.02 ±14.78 481.995 < 0.001 依恋 父子信任 37.59±7.78 35.65±7.91 33.11±8.87 264.169 < 0.001 父子交流 29.09±8.28 27.22±8.11 24.59±8.05 267.774 < 0.001 父子疏离 15.30±4.67 16.51±4.51 17.94±4.68 285.604 < 0.001 父子总分 51.38 ±18.20 46.35±17.91 39.76±18.82 353.737 < 0.001 母子信任 38.45±7.06 36.40±7.35 33.83±8.10 338.720 < 0.001 母子交流 31.45±7.59 29.52±7.42 26.66±7.84 345.718 < 0.001 母子疏离 14.97±4.31 16.27±4.21 17.94±4.35 417.537 < 0.001 母子总分 54.93±16.69 49.66±16.53 42.56±17.72 466.970 < 0.001 同伴信任 38.07±7.50 36.73±7.34 35.45±8.06 104.028 < 0.001 同伴交流 28.62±6.60 27.48±6.37 26.56±6.95 85.052 < 0.001 同伴疏离 18.30±4.04 19.36±3.86 20.14±4.10 189.903 < 0.001 同伴总分 48.38±15.22 44.85±14.63 41.86±15.99 160.472 < 0.001 抑郁得分 46.26±9.77 50.64±9.99 56.64±10.76 891.879 < 0.001
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表 3 2019年合肥中学生NSSI行为的多因素Logistic回归分析
Table 3. Analysis of multivariate Logistic regression of NSSI behavior among middle school students in 2019 in Hefei
变量 β值 sx值 Wald χ2值 OR(95% CI)值 P值 NSSI行为分组 反复 3.607 0.403 80.182 < 0.001 偶发 -0.752 0.584 1.656 0.198 无 1.000 抑郁 无 -0.621 a 0.293 a 4.480 a 0.538 a 0.034 a -2.151 b 0.211 b 104.215 b 0.116 b < 0.001 b 轻度 -0.318 a 0.291 a 1.192 a 0.728 a 0.275 a -1.378 b 0.208 b 43.739 b 0.252 b < 0.001 b 中度 -0.245 a 0.300 a 0.667 a 0.783 a 0.414 a -0.919 b 0.214 b 18.431 b 0.399 b < 0.001 b 重度 1.000 支持总分 -0.006 a 0.003 a 3.612 a 0.994 a 0.057 a -0.016 b 0.002 b 44.210 b 0.985 b < 0.001 b 依恋 母子依恋 -0.007 a 0.002 a 9.472 a 0.993 a 0.002 a -0.018 b 0.002 b 90.183 b 0.983 b < 0.001 b 父子依恋 -0.005 a 0.002 a 5.806 a 0.995 a 0.016 a -0.008 b 0.002 b 22.167 b 0.992 b < 0.001 b 同伴依恋 0.004 a 0.002 a 0.169 a 0.999 a 0.681 a 0.004 b 0.002 b 4.316 b 1.004 b 0.038 b 年级 初一 -0.050 a 0.109 a 0.028 a 0.952 a 0.648 a -0.042 b 0.087 b 0.237 b 0.958 b 0.627 b 初二 0.251 a 0.094 a 7.129 a 1.285 a 0.008 a -0.132 b 0.084 b 2.495 b 0.876 b 0.114 b 高一 -0.022 a 0.070 a 0.096 a 0.979 a 0.757 a -0.054 b 0.058 b 0.882 b 0.947 b 0.348 b 高二 1.000 居住地 城镇 0.196 a 0.072 a 7.398 a 1.216 a 0.007 a 0.246 b 0.060 b 16.700 b 1.279 b < 0.001 b 农村 1.000 兴趣 未失去 0.453 a 0.307 a 2.183 a 1.573 a 0.139 a -0.033 b 0.193 b 0.029 b 0.968 b 0.865 b 减少 0.782 a 0.306 a 6.552 a 2.186 a 0.010 a 0.275 b 0.192 b 2.049 b 1.317 b 0.152 b 大多失去 1.008 a 0.316 a 10.138 a 2.739 a 0.001 a 0.650 b 0.203 b 10.305 b 1.916 b 0.001 b 全部失去 1.000 睡眠质量 很好 -0.187 a 0.308 a 0.369 a 0.839 a 0.543 a -0.814 b 0.214 b 14.441 b 0.443 b < 0.001 b 比较好 0.068 a 0.301 a 0.051 a 1.070 a 0.822 a -0.427 b 0.205 b 4.324 b 0.653 b 0.038 b 一般 0.233 a 0.297 a 0.613 a 1.262 a 0.434 a -0.213 b 0.201 b 1.124 b 0.808 b 0.289 b 比较差 0.297 a 0.316 a 0.882 a 1.346 a 0.348 a 0.190 b 0.216 b 0.776 b 1.209 b 0.378 b 很差 1.000 注：a表示偶发NSSI行为组与无NSSI行为组的比较；b表示反复NSSI行为组与无NSSI行为组的比较。
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