大学生童年期不良经历暴露与非自杀性自伤行为的关联

The relationship between exposure to adverse childhood experience and non-suicidal self-injury behaviors among college students

目的探讨童年期不良经历(ACEs)暴露类型和时相与大学生非自杀性自伤(NSSI)行为的关联,为大学生NSSI行为防控提供参考。方法 2019年10—11月,整群选取安徽省2所不同城市的医学院校一、二年级在校学生,了解社会人口学指标、童年期不良经历和NSSI行为发生等信息,建立多因素logistics回归模型,分析ACEs不同暴露类型和时相与NSSI行为的关联。结果 7 623名大学生中NSSI行为检出率为16.46%(1 255例),男生检出率(24.10%)高于女生(13.80%),差异有统计学意义(P<0.05)。报告有ACEs大学生6 944人,占91.09%,其中持续暴露6 100人,占80.02%。多因素logistics回归分析显示,持续暴露于躯体忽视、情感忽视、躯体虐待、情感虐待、性虐待、家庭功能不全和ACEs显著增加大学生NSSI行为发生风险,OR(95%CI)值分别为1.60(1.38~1.86)、2.13(1.81~2.49)、4.32(3.53~5.25)、4.74(4.02~5.59)、3.88(2.70~5.58)、2.87(2.38~3.46)、5.26(3.55~7.79)(P值均<0.05);男生暴露于ACEs与NSSI行为发生风险关联强度更高,女生暴露于躯体虐待、情感虐待和性虐待与NSSI行为发生风险关联强度更高。结论不同类型和时相的童年期不良经历与大学生NSSI行为发生风险增加相关,建议开展针对性干预。

Objective To explore the relationship between the type, phase of adverse childhood experience(ACEs) exposure and college students′ non-suicidal self-injury(NSSI) behavior;to provide reference for the prevention and control of college students′ NSSI behavior. Methods From Oct to Nov 2019,a cluster of 1^(st) grade and 2^(nd) grade students from medical schools in 2 cities in Anhui province were selected, who were subjected to conduct a survey for their social demographic indicators, ACEs exposure and the occurrence of NSSI.A multivariate logistic regression model was established to analyze the association between different exposure types and phases of ACEs and NSSI behaviors. Results The positive rate of NSSI in 7 623 college students was 16.46%(1 255 cases).The positive NSSI rate of male students(24.10%) was higher than that of female students(13.80%),the difference was statistically significant(P<0.05).A total of 6 944 students were reported having ACEs exposure, accounted for 91.09%;among whom 6 100 were exposed continuously, accounted for 80.02%.Multivariate logistic regression analysis showed that continuous exposure to physical neglect, emotional neglect, physical abuse, emotional abuse, sexual abuse, family dysfunction, and ACEs significantly increased the risk of NSSI behaviors among college students, the corresponding OR(95%CI) values were 1.60(1.38-1.86),2.13(1.81-2.49),4.32(3.53-5.25),4.74(4.02-5.59),3.88(2.70-5.58),2.87(2.38-3.46),5.26(3.55-7.79),respectively(all P<0.05).There was a relatively stronger correlation between exposure to ACEs and the risk of NSSI behavior among male students;while correlations between exposure to physical abuse, emotional abuse, sexual abuse and the risk of NSSI behavior in female students were relatively stronger. Conclusion Different types and phases of ACEs are related to the risk of NSSI behaviors among college students;targeted interventions were suggested to be carried out.