安徽省中学生非自杀性自伤行为现状及其影响因素

胡燕; 徐慧琼; 万宇辉; 苏普玉; 范引光; 叶冬青

doi:10.16462/j.cnki.zhjbkz.2020.08.012

安徽省中学生非自杀性自伤行为现状及其影响因素

doi: 10.16462/j.cnki.zhjbkz.2020.08.012

胡燕^{1, 3},
徐慧琼²,
万宇辉²,
苏普玉²,
范引光¹,
叶冬青^1, ,

1.
230032 合肥, 安徽医科大学公共卫生学院流行病与卫生统计学教研室、炎症免疫性疾病安徽省实验室
2.
230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学教研室
3.
230601 合肥, 安徽医科大学护理学院基础护理学教研室

详细信息

通讯作者:
叶冬青, E-mail:anhuiydq@126.com

中图分类号: R181
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出版历程
- 收稿日期: 2020-02-05
- 修回日期: 2020-03-18
- 刊出日期: 2020-08-10

The status and influencing factors of non-suicidal self-injury among middle school students in Anhui Province

1.
Department of Epidemiology and Biostatiatics, School of Public Health, Anhui Medical University, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Hefei 230032, China
2.
Department of Maternal, Child& Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
3.
Department of Fundamental Nursing, School of Nursing, Anhui Medical University, Hefei 230601, China

More Information

Corresponding author: YE Dong-qing,E-mail:anhuiydq@126.com

摘要

摘要: 目的探索安徽省中学生非自杀性自伤行为（non-suicidal self-injury，NSSI）的现状及影响因素。方法采用分层整群抽样的方法选择3个地市共7 125名中学生进行问卷调查，比较不同人口学特征中学生的NSSI检出率差异，建立多因素Logistic回归模型分析相关因素与无NSSI、偶发NSSI和反复NSSI的关联。结果中学生无NSSI、偶发NSSI和反复NSSI的检出率分别是49.0%、21.4%和29.6%；男女生最多发的NSSI分别是用拳头击打硬物和掐伤自己；无NSSI、偶发NSSI和反复NSSI在不同性别、年级、留守状态和抑郁症状等之间的检出率差异均有统计学意义（均有P < 0.05）；男生、留守、轻度和中度级以上抑郁症状、较差的自评成绩、较少的好友个数均是偶发NSSI和反复NSSI的独立危险因素。结论安徽省中学生NSSI检出率较高，多种内外因素与NSSI的发生有关。
- 中学生 /
- 非自杀性自伤 /
- 抑郁症状
Abstract: Objective To describe the status and influencing factors of non-suicidal self-injury (NSSI) among middle school students in Anhui Province. Methods Designed questionnaires were delivered to 7 125 middle school students who were selected by stratified cluster sampling from 3 cities. The detection rate of NSSI was compared among different demographic characteristics. Multivariable Logistic regression models were used to explore the associations between correlation factors and non-NSSI, occasional NSSI and recurrent NSSI. Results The most common NSSI behaviors were hitting with fists among boys and pinching among girls. The detection rate of non-NSSI, occasional NSSI and repetitive NSSI were 49.0%, 21.4% and 29.6%, respectively. The differences of non-NSSI, occasional NSSI and repetitive NSSI detection rate between different genders and left-behind states, or among different grades and depressive symptoms were statistically significant (all P < 0.05). Being a boy, left-behind, mild and moderate depressive, having poor self-rated scoresand fewer friends were independent risk factors for occasional and repeated NSSI. Conclusion The detection rate of NSSI of Anhui middle school students is high, and a variety of internal and external factors are related to the engagement of NSSI.
- Middle school students /
- Non-suicidal self-injury /
- Depressive symptoms

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表 1 12种NSSI的检出情况及其在不同性别之间的比较[n(%)]

Table 1. The detection status of 12 NSSI and the comparison between genders [n(%)]

NSSI	总人数	男生	女生	χ²值	P值
无明显组织损伤
故意掐伤自己	1 315(18.5)	625(15.6)	690(22.0)	47.767	< 0.001
故意抓伤自己	793(11.1)	400(10.0)	393(12.6)	11.478	< 0.001
故意用头撞较硬的物体(墙、树等)	950(13.3)	597(14.9)	353(11.3)	20.408	< 0.001
故意用拳头打墙、桌子、窗户和地面等硬物	2 151(30.2)	1 504(37.6)	647(20.7)	239.981	< 0.001
故意用拳头、巴掌或较硬的物体打伤自己	750(10.5)	478(12.0)	272(8.7)	19.984	< 0.001
故意咬伤自己	695(9.8)	304(7.6)	391(12.5)	47.526	< 0.001
故意拽掉自己的头发	1 098(15.4)	612(15.3)	486(15.6)	0.058	0.417
有明显组织损伤
故意扎或刺伤自己(如用针、订书钉、笔尖等)	451(6.3)	212(5.3)	239(7.6)	16.058	< 0.001
故意割伤自己(如用刀片、玻璃等)	556(7.8)	217(5.4)	339(10.8)	71.102	< 0.001
故意烧伤或烫伤自己(如用烟头、开水、打火机或火柴等)	96(1.3)	57(1.4)	39(1.2)	0.431	0.291
用东西故意摩擦皮肤使其出血或淤血	412(5.8)	193(4.8)	219(7.0)	15.110	< 0.001
故意在皮肤上刻字或符号(不包括纹身)	1 077(15.1)	560(14.0)	517(16.5)	8.549	0.002

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表 2 NSSI总次数的检出情况及其在不同性别之间的比较[n(%)]

Table 2. The detection status of the total number of NSSI and the comparison between genders [n(%)]

项目	无NSSI(n=3 493)	偶发NSSI(n=1 522)(次)				反复NSSI(n=2 110) (次)
项目	无NSSI(n=3 493)	1	2	3	4	5	6~	11~	≥16
男生	1 900(47.6)	242(6.1)	283(7.1)	187(4.7)	147(3.7)	133(3.3)	404(10.1)	210(5.3)	589(12.5)
女生	1 593(50.9)	215(6.9)	203(6.5)	149(4.8)	96(3.1)	97(3.1)	289(9.2)	158(5.0)	330(10.6)
总人数	3 493(49.0)	457(6.4)	486(6.9)	336(4.7)	243(3.4)	230(3.2)	693(9.8)	368(5.1)	819(11.1)

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表 3 不同人口统计学特征中学生NSSI检出率的差异情况[n(%)]

Table 3. Differences in NSSI detection rate among middle school students with different demographic characteristics[n(%)]

变量	人数	无NSSI	偶发NSSI	反复NSSI	Z/χ²值	P值
性别					3.063	0.002
男	3 995	1 900(47.6)	859(21.5)	1 236(30.9)
女	3 130	1 593(50.9)	663(21.2)	874(27.9)
年级					36.512	< 0.001
初一	1 018	563(55.3)	218(21.4)	237(23.3)
初二	1 245	645(51.8)	241(19.4)	359(28.8)
初三	903	416(46.1)	176(19.5)	311(34.4)
高一	1 477	686(46.4)	336(22.7)	455(30.8)
高二	1 492	687(46.0)	353(23.7)	452(30.3)
高三	990	496(50.1)	198(20.0)	296(29.9)
是否留守					6.215	< 0.001
是	3 426	1 561(45.6)	741(21.6)	1 124(32.8)
否	3 699	1 932(52.2)	781(21.1)	986(26.7)
家庭形态					22.765	< 0.001
核心家庭	4 166	2 102(50.5)	887(21.3)	1 177(28.3)
主干家庭	2 094	1 019(48.7)	442(21.1)	633(30.2)
单亲家庭	334	135(40.4)	66(19.8)	133(39.8)
联合家庭	357	162(45.4)	84(23.5)	111(31.1)
重组家庭	174	75(43.1)	43(24.7)	56(32.2)
自评家庭经济情况					19.468	< 0.001
较差	1 082	479(44.3)	215(19.9)	388(35.9)
一般	4 899	2 444(49.9)	1 072(21.9)	1 383(28.2)
较好	1 144	570(49.8)	235(20.5)	339(29.6)
是否寄宿					2.825	0.005
是	2 436	1 246(51.1)	515(21.1)	675(27.7)
否	4 689	2 247(47.9)	1 007(21.5)	1 435(30.6)
自评成绩情况					99.310	< 0.001
优秀	639	380(59.5)	109(17.1)	150(23.5)
良好	2 078	1 071(51.5)	445(21.4)	562(27.0)
一般	3 176	1 567(49.3)	697(21.9)	912(28.7)
较差	1 232	475(38.6)	271(22.0)	486(39.4)
好友个数(个)					19.404	< 0.001
0	230	96(41.7)	37(16.1)	97(42.2)
1~	2 207	1 005(45.5)	494(22.4)	708(32.1)
3~	2 845	1 431(50.3)	626(22.0)	788(27.7)
≥6	1 843	961(52.1)	365(19.8)	517(28.1)
抑郁症状					342.521	< 0.001
无抑郁	6 428	3 341(52.0)	1 405(21.9)	1 682(26.2)
轻度抑郁	644	140(21.7)	112(17.4)	392(60.9)
中度及以上	53	12(22.6)	5(9.4)	36(67.9)

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表 4 NSSI发生频率的多因素Logistic回归分析模型分析

Table 4. Analysis of multivariate Logistic regression analysis model of occurrence frequency of NSSI

变量	β	S_x	Waldχ²值	OR(95% CI)值	P值
NSSI类型
反复自伤	-1.376	0.173	63.076	0.25(0.18~0.35)	< 0.001
偶发自伤	-0.411	0.173	5.684	0.66(0.47~0.93)	0.017
无自伤				1.00
性别
男				1.00
女	0.260	0.047	29.904	1.30(1.18~1.42)	< 0.001
年级
初一				1.00
初二	-0.182	0.084	4.749	0.83(0.71~0.98)	0.029
初三	-0.353	0.089	15.865	0.70(0.59~0.84)	< 0.001
高一	-0.205	0.081	6.352	0.81(0.69~0.96)	0.012
高二	-0.232	0.081	8.188	0.79(0.68~0.93)	0.004
高三	-0.097	0.089	1.201	0.91(0.76~1.08)	0.273
留守
无				1.00
有	-0.231	0.048	23.140	0.79(0.72~0.87)	< 0.001
家庭型态
核心家庭				1.00
主干家庭	-0.012	0.053	0.051	0.99(0.89~1.10)	0.821
单亲家庭	-0.277	0.110	6.310	0.76(0.61~0.94)	0.012
联合家庭	-0.117	0.106	1.228	0.89(0.72~1.09)	0.268
重组家庭	-0.121	0.149	0.669	0.89(0.66~1.19)	0.413
自评家庭经济情况
较差				1.00
一般	0.088	0.066	1.769	1.09(0.99~1.29)	0.184
较好	-0.040	0.085	0.216	0.96(0.87~1.22)	0.642
寄宿
无				1.00
有	0.171	0.051	11.472	1.19(1.07~1.31)	0.001
自评成绩情况
优秀				1.00
良好	-0.304	0.090	11.497	0.74(0.62~0.88)	0.001
一般	-0.324	0.087	13.750	0.72(0.61~0.86)	< 0.001
较差	-0.653	0.098	44.626	0.52(0.43~0.63)	< 0.001
好友个数(个)
0				1.00
1~	0.032	0.135	0.058	1.03(0.79~1.35)	0.810
3~	0.128	0.134	0.910	1.14(0.87~1.48)	0.340
≥6	0.156	0.137	1.300	1.17(0.89~1.53)	0.254
抑郁症状
无				1.00
轻度	-1.397	0.084	274.755	0.25(0.21~0.29)	< 0.001
中度及以上	-1.688	0.288	34.460	0.18(0.11~0.32)	< 0.001

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