中学生童年期虐待与非自杀性自伤行为的关联

Relationship between childhood abuse experience and non-suicidal self-injury in middle school students

目的分析童年期虐待和中学生非自杀性自伤行为(non-suicidal self-injury,NSSI)的关联及性别差异,为中学生NSSI的防控提供参考。方法采用分层整群抽样方法,选取郑州、深圳、南昌和贵阳4个地区14 500名在校高中和初中学生,采用童年期虐待问卷和NSSI问卷等进行调查,了解一般人口统计学指标、童年期虐待经历和NSSI等信息,建立多因素Logistic回归模型分析童年期虐待经历与NSSI的关联,比较关联强度的性别差异。结果中学生NSSI检出率为9.5%,男生(10.7%)高于女生(8.3%),差异有统计学意义(χ2=22.77,P<0.01)。多因素Logistic回归分析显示,随着不同形式的童年期虐待水平升高,中学生NSSI呈增加趋势;控制相关混杂因素的影响,高水平各种形式的童年期虐待均与中学生NSSI的增加有关(P值均<0.01);高水平性虐待、情感忽视和童年期虐待与女生NSSI的关联强度高于男生(P值均<0.01)。结论童年期虐待经历是中学生NSSI的重要影响因素,特别在女生群体中。开展针对性干预有益于中学生NSSI的防控。

Objective To investigate the relationship between childhood abuse experience and non-suicidal self-injury in middle school students, and gender differences of the relationship. Methods Stratified cluster sampling method was used to select 14 500 middle school students from Shenzhen, Zhengzhou, Nanchang and Guiyang as participants. Questionnaire survey was conducted to collect information on demographic indicators, childhood abuse experiences and non-suicidal self-injury, etc. Logistic regression was used to analyze the relationship between childhood abuse experience and non-suicidal self-injury, and gender differences. Results The prevalence of NSSI was 9.5%,while it was higher among male students( 10.7%) than female students( 8.3%)( χ2= 22.77,P<0.01). The rate of NSSI was higher with the increasing exposure of childhood abuse. High levels of multiple forms of childhood abuse had independent effects on NSSI among total samples after controlling for confounding factors( P<0.01). In middle school students with high levels of sexual abuse, emotional neglect and childhood abuse, females versus males had higher risk to have NSSI( P<0.01). Conclusion Childhood abuse experiences were associated with increased risk of NSSI among middle school students, especially among girls. Groups at highest risk of NSSI in relation to certain types of childhood abuse should be targeted with interventions accordingly.