背景:近年来,青少年抑郁症患者的数量逐年增加,与个体经常表现出非自杀自我伤害(NSSI)行为。这项研究的目的是调查家庭(儿童虐待),学校(同伴受害),和个体(心理弹性)因素的青少年抑郁症伴或不伴NSSI(中文版的功能评估[C-FASM]量表),并分析上述心理因素和社会因素与NSSI发生频率的相关性,为青少年抑郁症患者NSSI的预防和干预提供依据。
方法:我们招募了355名患有抑郁症状的青少年参与本研究,并根据C-FASM量表将他们分为NSSI组(N=227)和非NSSI组(N=128)。简短形式的儿童创伤问卷(CTQ-SF),多维对等可视化规模(MPVS),比较两组青少年的中国青少年心理弹性量表(RISC)评分。采用Pearson相关系数分析NSSI频率与上述评分的相关性。
结果:情绪虐待,身体虐待,性虐待,情感上的忽视,身体上的忽视,NSSI组的CTQ-SF总分明显高于n-NSSI组(均p<0.001)。身体上的伤害,口头受害,社会操纵,对财产的攻击,NSSI组MPVS总分明显高于n-NSSI组(p<0.001,p<0.001,p=0.009,p<0.001,p<0.001)。目标集中,情绪调节,积极的感知,家庭支持,人际援助,NSSI组的RISC总分显著低于n-NSSI组(均p<0.001)。NSSI的频率与情绪虐待呈显著正相关,身体虐待,性虐待,情感上的忽视,身体上的忽视,CTQ-SF总评分(r=0.366,p<0.001;r=0.411,p<0.001;r=0.554,p<0.001;r=0.220,p=0.001;r=0.255,p<0.001;r=0.673,p<0.001)。NSSI的频率与身体伤害呈显著正相关,口头受害,社会操纵,对财产的攻击,和MPVS总分(r=0.418,p<0.001;r=0.455,p<0.001;r=0.447,p<0.001;r=0.555,p=0.001;r=0.704,p<0.001)。NSSI频率与目标浓度呈显著负相关,情绪调节,积极的感知,家庭支持,人际援助,和RISC总分(r=-0.393,p<0.001;r=-0.341,p<0.001;r=-0.465,p<0.001;r=-0.272,p=0.001;r=-0.160,p=0.016;r=-0.540,p<0.001)。
结论:我们的发现强调了家庭(童年虐待)的重要性,学校(同伴受害),抑郁青少年NSSI的个体(心理弹性)因素,这些因素与NSSI频率密切相关。
结论:保持良好的家庭环境,解决学校同伴受害的问题,制定相应的提高心理韧性的措施,对于改善抑郁青少年的心理健康状况,降低NSSI风险具有重要意义。
BACKGROUND: In recent years, the number of adolescents with depression has been increasing annually, with individuals often exhibiting non-suicidal self-injury (NSSI) behavior. The purpose of this study is to investigate the family (childhood abuse), school (peer victimization), and individual (psychological resilience) factors of adolescents with depression with or without NSSI (the Chinese version of the Functional Assessment of Self-Mutilation [C-FASM] scale), and to analyze the correlation between the above psychological and social factors and the frequency of NSSI, to provide a basis for NSSI prevention and intervention in adolescents with depression.
METHODS: We recruited 355 adolescents with depressive symptoms to participate in this study and divided them into Group NSSI (N = 227) and Group no-NSSI (n-NSSI) (N = 128) based on the C-FASM scale. The Short-Form Childhood Trauma Questionnaire (CTQ-SF), Multidimensional Peer Visualization Scale (MPVS), and Resilience Scale for Chinese Adolescents (RISC) scores were compared between two groups of adolescents. Pearson correlation coefficient was used to analyze the correlation between NSSI frequency and the above scores.
RESULTS: Emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, and total CTQ-SF score in Group NSSI were significantly higher than those in Group n-NSSI (all p < 0.001). Physical victimization, verbal victimization, social manipulation, attacks on property, and total MPVS score in Group NSSI were significantly higher than those in Group n-NSSI (p < 0.001, p < 0.001, p = 0.009, p < 0.001, p < 0.001). Goal concentration, emotion regulation, positive perception, family support, interpersonal assistance, and total RISC score in Group NSSI were significantly lower than those in Group n-NSSI (all p < 0.001). The frequency of NSSI was significantly positively correlated with emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, and total CTQ-SF score (r = 0.366, p < 0.001; r = 0.411, p < 0.001; r = 0.554, p < 0.001; r = 0.220, p = 0.001; r = 0.255, p < 0.001; r = 0.673, p < 0.001). The frequency of NSSI was significantly positively correlated with physical victimization, verbal victimization, social manipulation, attacks on property, and total MPVS score (r = 0.418, p < 0.001; r = 0.455, p < 0.001; r = 0.447, p < 0.001; r = 0.555, p = 0.001; r = 0.704, p < 0.001). The frequency of NSSI was significantly negatively correlated with goal concentration, emotion regulation, positive perception, family support, interpersonal assistance, and total RISC score (r = -0.393, p < 0.001; r = -0.341, p < 0.001; r = -0.465, p < 0.001; r = -0.272, p = 0.001; r = -0.160, p = 0.016; r = -0.540, p < 0.001).
CONCLUSIONS: Our findings highlight the importance of family (childhood abuse), school (peer victimization), and individual (psychological resilience) factors for NSSI in depressed adolescents, and these factors are closely related to NSSI frequency.
CONCLUSIONS: Maintaining a good family environment, solving the problem of peer victimization at school, and developing corresponding measures to improve psychological resilience are of great significance for improving the mental health of depressed adolescents and reducing the risk of NSSI.