独生与非独生青少年情绪障碍患者非自杀性自伤行为差异的横断面研究

Differences in non-suicidal self-injury behaviors between only-child and non-only-child adolescents with mood disorders: a cross-sectional study

摘要:

目的 了解独生与非独生青少年情绪障碍患者非自杀性自伤（non-suicidal self-injury，NSSI）行为的差异。 方法 运用三阶段抽样方法，于2020年8月至2020年11月在全国9个省份20家精神疾病医院门诊对529名12~18岁患有情绪障碍伴NSSI行为的青少年进行横断面调查。使用自编量表收集一般人口学信息，使用自伤功能评估问卷、贝克自杀意念量表、凯斯勒心理困扰量表、内隐压力心智量表、感知社会支持的多维度量表、多维学生生活满意度量表和罗森伯格自尊量表收集情绪障碍青少年自伤行为和心理因素相关信息。 结果 共调查529名患有情绪障碍伴NSSI的青少年，其中独生子女375例，非独生子女154例。独生子女组自伤功能评估问卷总分高于非独生子女组（P<0.05）；独生子女组自伤种类及自伤频次高于非独生子女组（P<0.05）。心理特征分析显示，独生子女组自尊得分低于非独生子女组（P<0.05）；独生子女组心理困扰得分及抑郁症状得分高于非独生子女组（P<0.05）。多重线性回归分析显示：在独生和非独生的情绪障碍青少年中，其自杀意念得分均与NSSI行为频次呈正相关（P<0.05）；自尊水平与独生子女NSSI行为频次呈负相关（P<0.05），压力感知得分与独生子女NSSI行为频次呈正相关（P<0.05）；焦虑情绪得分与非独生子女NSSI频次呈正相关（P<0.05）。 结论 情绪障碍伴NSSI行为的青少年中，独生子女有更多的自伤频次和更差的心理健康状况，因此，情绪障碍伴NSSI行为的独生子女需要更多关注。

Abstract:

Objective To investigate the differences in non-suicidal self-injury (NSSI) behaviors between only-child and non-only-child adolescents with mood disorders. Methods A three-stage sampling method was used to perform a cross-sectional survey of 529 adolescents, aged 12-18 years, who had mood disorders and NSSI behaviors. These adolescents were sampled from the outpatient service of 20 mental hospitals in 9 provinces of China from August to November 2020. A self-made questionnaire was used to collect general demographic data. The Functional Assessment of Self-Mutilation, Beck Scale for Suicide Ideation, Kessler Psychological Distress Scale, Stress Mindset Measure-General, Multidimensional Scale of Perceived Social Support, Multidimensional Students' Life Satisfaction Scales, and Rosenberg Self-Esteem Scale were used to collect the information on self-injury behaviors and psychological factors in these adolescents. Results A total of 529 adolescents with mood disorders and NSSI behaviors were surveyed, among whom 375 were only-child adolescents and 154 were non-only-child adolescents. Compared with the non-only-child group, the only-child group had a significantly higher total score of Functional Assessment of Self-Mutilation (P<0.05) .The type and frequency of self-injury in the only-child group were significantly higher than those in the non-only-child group (P<0.05). Psychological analysis showed that compared with the non-only-child group, the only-child group had a significantly lower score of self-esteem (P<0.05) and significantly higher scores of psychological distress and depressive symptoms (P<0.05). The multiple linear regression analysis showed that the score of suicidal ideation was positively correlated with the frequency of NSSI behaviors in both only-child and non-only-child adolescents with mood disorders (P<0.05); in the only-child adolescents, the level of self-esteem was negatively correlated with the frequency of NSSI behaviors (P<0.05), and the score of stress perception was positively correlated with the frequency of NSSI behaviors (P<0.05); in the non-only-child adolescents, the score of anxious emotion was positively correlated with the frequency of NSSI behaviors (P<0.05). Conclusions Among the adolescents with mood disorders and NSSI behaviors, the only-child adolescents tend to have a higher frequency of self-injury and poorer mental health, and therefore, the only-child adolescents with mood disorders and NSSI behaviors need more attention.