中国农村地区青少年忽视及躯体虐待经历与非自杀性自伤行为的关联

目的探讨中国农村地区青少年忽视及躯体虐待经历与非自杀性自伤行为的关系,为青少年非自杀性自伤行为的预防和干预提供科学依据。方法采用多阶段分层随机整群抽样方法,在安徽、广东、云南、黑龙江、湖北5个省份抽取14162名中学生进行问卷调查,分析忽视及躯体虐待与自伤行为的相关性。结果农村地区中学生在调查前1年,自伤行为的自我报告率为13.5%,偶有自伤行为的自我报告率为15.4%。单因素分析显示,忽视、躯体虐待种类与反复自伤行为、偶有自伤行为均相关(P值均<0.01);控制性别、民族、是否独生子女、家庭结构、家庭经济状况、父母学历因素后,多分类Logistic回归分析显示,忽视、躯体虐待种类数均与反复自伤行为和偶有自伤行为呈正相关(OR=1.43~3.23,P值均<0.01),且随着躯体虐待种类的增加,自伤行为发生的风险呈上升趋势。结论忽视及躯体虐待经历是中国农村地区青少年自伤行为的重要危险因素,应加强对青少年忽视及虐待干预,减少自伤行为的发生。

Associations of neglect and physical abuse with non-suicidal self-injury behaviors among adolescents in rural China

Objective To investigate the relationship between neglect,physical abuse and non-suicidal self-injury(NSSI)behaviors among middle school students in rural China.Methods A total of 14 162 adolescents in Anhui,Guangdong,Yunnan,Heilongjiang and Hubei provinces were selected by multi-stage cluster random sampling method.Data were obtained on demographic information,neglect,physical abuse and non-suicidal self-injury from questionnaire survey.Results During the past year before survey,13.5%of participants engaged in self-injury 5 times or more,15.4%of participants engaged in self-injury 1 to 4 times.Both neglect and physical abuse were significantly associated with self-injury in adolescents(P<0.01).After adjusted for gender,ethnicity,the only-one child,family structure,family economic status,and other variables,multinomial logistic regression showed that neglect and physical abuse were positively asociated with self-injury behavior(OR=1.43-3.23).There was a potential dose-response relationship of accumulating physical abuse types and self-injury,with more physical abuse types,the higher risk of self-injury behavior.Conclusion Neglect and physical abuse experience should be considered as a risk factor for NSSI among adolescents in rural China.Specific intervention targeting neglect and physical abuse should be strengthened to reduce the occurrence of NSSI.