情绪障碍青少年非自杀性自伤行为的性别差异

Gender differences in non-suicidal self-injury behaviors among adolescents with mood disorders

目的探讨中国患有情绪障碍的青少年非自杀性自伤行为(non-suicidal self-injury,NSSI)的性别差异,为青少年NSSI行为预防和干预提供科学依据,保障青少年的健康成长。方法本研究采用横断面调查的方法,对我国9个省份20家精神疾病医院门诊患有情绪障碍伴发NSSI行为的青少年的NSSI行为方式、次数和自伤功能进行调查。同时采用Beck自杀意念量表、凯斯勒心理困扰量表,压力心态测验量表和罗森伯格自尊量表评估研究对象的心理状况。结果本研究共调查了673名患情绪障碍伴发NSSI的青少年;女性青少年自伤次数[13.00(8.00,20.00)]次高于男性[11.00(4.50,19.00)]次(Z=-2.358,P=0.018);女性青少年采取自伤方式的种类[5.00(3.00,7.00)]种多于男性[5.00(2.00,7.00)]种(Z=-2.859,P=0.004);男性第一次自伤年龄略高于女性(F=4.438,P=0.036)。自伤原因分析显示,女性青少年情绪调节原因得分高于男性(F=15.859,P<0.05)。心理特征分析显示,女性青少年心理困扰水平高于男性(F=12.052,P=0.001);但男性青少年压力感知水平高于女性(F=5.937,P=0.015)。结论我国不同性别青少年情绪障碍患者NSSI行为在自伤频率、方式和原因上存在一定的性别差异,女性青少年自伤行为频率远高于男性,并且表现出更多的情绪调节原因。因此,通过对青少年,特别是女性青少年不良情绪调节方式和调节策略进行干预,可能是预防其自伤行为的重要手段。

Objective To discuss the gender differences in non-suicidal self-injury(NSSI)behaviors of Chinese adolescents with mood disorders.Methods A cross-sectional survey was conducted to investigate the methods,frequency and function of NSSI among adolescents with mood disorders recruited in outpatient departments of 20 psychiatric hospitals in 9 provinces of China.Functional assessment of self-mutilation was used to assess the NSSI behaviors of subjects.Beck suicide ideation scale(BSI),the 10-item Kessler psychological distress scale(K10),Rosenberg self-esteem scale(RSE)and stress mindset measure(SMM-G)were used to evaluate adolescents′suicidal ideation,psychological distress,self-esteem and stress mindset.Results A total of 673 adolescents with mood disorders and NSSI were included in the survey.The frequency of NSSI was higher in female adolescents than that in male adolescents[13.00(8.00,20.00)vs 11.00(4.50,19.00)](Z=-2.358,P=0.018).Meanwhile,female adolescents engamed in NSSI in more variety of forms than their male counterpart[5.00(3.00,7.00)vs 5.00(2.00,7.00)](Z=-2.859,P=0.004).The age of first NSSI in males was slightly older than that in females(F=4.438,P=0.036).The scores of emotional regulation reason of female adolescents were significantly higher than that of male adolescents(F=15.859,P<0.05)and the level of psychological distress of female adolescents was higher than that of male adolescents(F=12.052,P=0.001).However,the stress perception level of male adolescents was higher than that of female adolescents(F=5.937,P=0.015).Conclusions There are gender differences in the frequency,method and cause of NSSI behavior in adolescents with mood disorders in China.The frequency of NSSI in female adolescents is much higher than that in male adolescents,and female adolescents also have higher score of emotion regulation.Therefore,the intervention on negative emotional regulation methods and regulation strategies,especially for female adolescents,might be an important approach for the prevention of NSSI.