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Prevalence of and risk factors for non-suicidal self-injury in rural China: Results from a nationwide survey in China.
J Affect Disord 2018; 226:188-195JA

Abstract

BACKGROUND

Non-suicidal self-injury (NSSI) is a highly prevalent and serious public health problem among adolescents worldwide. However, to date there were no studies assessing the prevalence of NSSI defined by suggested DSM-5 criteria among Chinese adolescents. We aimed to conduct a nationwide survey to explore the prevalence of and risk factors for NSSI among school-based adolescents in rural China.

METHODS

A total sample of 15,623 adolescents in rural China were enrolled by using a multistage sampling method. Data was collected by self-report questionnaires including demographic characteristics, neglect, maltreatment, loneliness, resilience, social support and emotional management ability. NSSI was defined by suggested DSM-5 criteria, according to which the engagement in self-injury took place more than 5 times a year. Multinomial logistic regression models were used to estimate the association between risk factors and NSSI.

RESULTS

There were 12.2% of adolescents (n = 1908) met the suggested DSM-5 criteria. Approximately 29% reported a history of NSSI at least once during the last year. Significant differences were found in several demographic factors including gender, ethnicity, grade, and family structure between adolescents with and without experiencing NSSI. The top three NSSI behaviors among adolescents with NSSI experience were hitting self, pinching, and pulling hair, with a prevalence rate of 16.7%, 14.1% and 11.2%, respectively. Female, Han ethnicity, fathers' education level, neglect, maltreatment, loneliness, social support, suicidal behaviors and emotional management ability were significantly associated with NSSI by multivariate analysis. No significant relationship was found between resilience and risk of NSSI.

LIMITATION

The DSM-5 has proposed 6 groups of criteria for NSSI, we only used criteria on frequency given its more accepted feasibility and pragmatic application. Consequently, it may different from other prevalence that estimated by other criteria.

CONCLUSION

To the best of our knowledge, this is the first study reporting prevalence of NSSI defined by suggested DSM-5 criteria among adolescent in rural China. In comparison to finding from the similar samples of adolescents, Chinese rural adolescents seem to have a relative higher prevalence. The potential risk factors for NSSI include female, father's education, Han ethnicity, psychosocial factors and suicide behaviors. More evidence for further understanding of context of the occurrence, improving access to health care utilization, and identifying the role of psychosocial factors and family relationship, is needed for the prevention and management of NSSI.

Authors+Show Affiliations

Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address: gytanjie@163.com.Department of Clinical Epidemiology & Biostatistics, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON L8S 4L8, United States. Electronic address: lig28@mcmaster.ca.Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China. Electronic address: 1259645213@qq.com.Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China. Electronic address: 237572461@qq.com.Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China. Electronic address: zhangym901229@163.com.Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China. Electronic address: Changhj0812@126.com.Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China. Electronic address: 1529278648@qq.com.Department of Nutrition and Food Hygiene, Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China. Electronic address: mxg@zju.edu.cn.Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China. Electronic address: wjiaji@163.com.Department of Child & Women Health Care, School of Public Health, Tongji Medical University, Huazhong University of Science &Technology, Wuhan, China. Electronic address: yuyizhen650@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28988001

Citation

Tang, Jie, et al. "Prevalence of and Risk Factors for Non-suicidal Self-injury in Rural China: Results From a Nationwide Survey in China." Journal of Affective Disorders, vol. 226, 2018, pp. 188-195.
Tang J, Li G, Chen B, et al. Prevalence of and risk factors for non-suicidal self-injury in rural China: Results from a nationwide survey in China. J Affect Disord. 2018;226:188-195.
Tang, J., Li, G., Chen, B., Huang, Z., Zhang, Y., Chang, H., ... Yu, Y. (2018). Prevalence of and risk factors for non-suicidal self-injury in rural China: Results from a nationwide survey in China. Journal of Affective Disorders, 226, pp. 188-195. doi:10.1016/j.jad.2017.09.051.
Tang J, et al. Prevalence of and Risk Factors for Non-suicidal Self-injury in Rural China: Results From a Nationwide Survey in China. J Affect Disord. 2018 01 15;226:188-195. PubMed PMID: 28988001.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of and risk factors for non-suicidal self-injury in rural China: Results from a nationwide survey in China. AU - Tang,Jie, AU - Li,Guowei, AU - Chen,Baoxin, AU - Huang,Zhijie, AU - Zhang,Yanmei, AU - Chang,Hongjuan, AU - Wu,Chunxia, AU - Ma,Xiaoguang, AU - Wang,Jiaji, AU - Yu,Yizhen, Y1 - 2017/09/28/ PY - 2017/03/05/received PY - 2017/09/07/revised PY - 2017/09/22/accepted PY - 2017/10/11/pubmed PY - 2018/5/5/medline PY - 2017/10/9/entrez KW - Emotional management KW - Loneliness KW - Maltreatment KW - Neglect KW - Non-suicidal self-injury KW - Social support SP - 188 EP - 195 JF - Journal of affective disorders JO - J Affect Disord VL - 226 N2 - BACKGROUND: Non-suicidal self-injury (NSSI) is a highly prevalent and serious public health problem among adolescents worldwide. However, to date there were no studies assessing the prevalence of NSSI defined by suggested DSM-5 criteria among Chinese adolescents. We aimed to conduct a nationwide survey to explore the prevalence of and risk factors for NSSI among school-based adolescents in rural China. METHODS: A total sample of 15,623 adolescents in rural China were enrolled by using a multistage sampling method. Data was collected by self-report questionnaires including demographic characteristics, neglect, maltreatment, loneliness, resilience, social support and emotional management ability. NSSI was defined by suggested DSM-5 criteria, according to which the engagement in self-injury took place more than 5 times a year. Multinomial logistic regression models were used to estimate the association between risk factors and NSSI. RESULTS: There were 12.2% of adolescents (n = 1908) met the suggested DSM-5 criteria. Approximately 29% reported a history of NSSI at least once during the last year. Significant differences were found in several demographic factors including gender, ethnicity, grade, and family structure between adolescents with and without experiencing NSSI. The top three NSSI behaviors among adolescents with NSSI experience were hitting self, pinching, and pulling hair, with a prevalence rate of 16.7%, 14.1% and 11.2%, respectively. Female, Han ethnicity, fathers' education level, neglect, maltreatment, loneliness, social support, suicidal behaviors and emotional management ability were significantly associated with NSSI by multivariate analysis. No significant relationship was found between resilience and risk of NSSI. LIMITATION: The DSM-5 has proposed 6 groups of criteria for NSSI, we only used criteria on frequency given its more accepted feasibility and pragmatic application. Consequently, it may different from other prevalence that estimated by other criteria. CONCLUSION: To the best of our knowledge, this is the first study reporting prevalence of NSSI defined by suggested DSM-5 criteria among adolescent in rural China. In comparison to finding from the similar samples of adolescents, Chinese rural adolescents seem to have a relative higher prevalence. The potential risk factors for NSSI include female, father's education, Han ethnicity, psychosocial factors and suicide behaviors. More evidence for further understanding of context of the occurrence, improving access to health care utilization, and identifying the role of psychosocial factors and family relationship, is needed for the prevention and management of NSSI. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/28988001/Prevalence_of_and_risk_factors_for_non_suicidal_self_injury_in_rural_China:_Results_from_a_nationwide_survey_in_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(17)30468-8 DB - PRIME DP - Unbound Medicine ER -