中学生非自杀性自伤流行现状及影响因素分析

Analysis of the Current Epidemiological Status and Influencing Factors of Non-Suicidal Self-Injury among Middle School Students

摘要: 目的：本研究旨在探索中学生非自杀性自伤流行现状及影响因素分析，为深入研究非自杀性自伤的干预措施提供新思路。方法：本研究采用分层随机整群抽样方式，选取重庆市长寿区、綦江区的5所中学，以班级为单位进行整群抽样调查。采用自制一般信息调查问卷评估青少年的人口学资料和基本情况，采用青少年自我伤害问卷、童年期创伤问卷(Childhood Trauma Questionnaire, CTQ)、自尊量表(Self-Esteem Scale, SES)分别评估中学生的非自杀性自伤行为情况、童年创伤情况及自尊水平。结果：共发放问卷3316份，剔除数据缺失、重复作答等无效问卷后，回收3186份，问卷回收有效率96.08%。中学生非自杀性自伤行为检出率为17.83%；中学生女性NSSI的发生率高于男性(χ² = 22.761, P < 0.01)、有吸烟史的青少年NSSI发生率高于无吸烟史的青少年(χ² = 31.227, P < 0.01)、有酗酒史的青少年NSSI发生率高于无酗酒史的青少年(χ² = 97.045, P < 0.01)、有网络成瘾史的青少年NSSI发生率高于无网络成瘾史的青少年(χ² = 92.239, P < 0.01)、父亲教育年限(χ² = 12.234, P < 0.01)和母亲教育年限(χ² = 13.957, P < 0.01)越低，青少年NSSI发生率越高。家庭教育方式(χ² = 91.571, P < 0.01)差异具有统计学意义。Logistic回归分析，结果发现青少年有饮酒史(OR = 2.795, P = 0.000)、网络成瘾(OR = 0.339, P = 0.000)史及其家庭教育方式(专断型) (OR = 1.912, P = 0.003)、家庭教育方式(忽视型) (OR = 3.788, P = 0.000)是青少年出现非自杀性自伤行为的独立危险因素。结论：中学生NSSI行为的检出率为17.83%，与自尊水平呈负相关，与童年创伤经历呈正相关，女性、文化程度、吸烟、酗酒、网络成瘾及(专断型 + 忽视型)家庭教育方式为青少年NSSI发生的独立危险因素。

Abstract: Objective: This study aims to explore the epidemiological status and influencing factors of non-suicidal self-injury (NSSI) among middle school students, providing new insights for in-depth research on intervention measures for NSSI. Methods: Using stratified random cluster sampling, this study selected five middle schools in Changshou and Qijiang districts of Chongqing, and conducted cluster sampling surveys with classes as the unit. A self-designed general information questionnaire was used to assess the demographic information and basic situation of adolescents. The Adolescent Self-harm Inventory, Childhood Trauma Questionnaire (CTQ), and Self-Esteem Scale (SES) were employed to evaluate NSSI behavior, childhood trauma, and self-esteem levels among middle school students, respectively. Results: A total of 3316 questionnaires were distributed, and after excluding invalid questionnaires due to missing data or repeated responses, 3186 questionnaires were recovered, with an effective recovery rate of 96.08%. The detection rate of NSSI behavior among middle school students was 17.83%. The incidence of NSSI among female students was higher than that among male students (χ² = 22.761, P < 0.01). Adolescents with a history of smoking had a higher incidence of NSSI than those without (χ² = 31.227, P < 0.01). Similarly, adolescents with a history of alcohol abuse had a higher incidence of NSSI than those without (χ² = 97.045, P < 0.01). Adolescents with a history of internet addiction also had a higher incidence of NSSI than those without (χ² = 92.239, P < 0.01). Lower educational attainment of both the father (χ² = 12.234, P < 0.01) and mother (χ² = 13.957, P < 0.01) was associated with a higher incidence of NSSI among adolescents. There were statistically significant differences in family education styles (χ² = 91.571, P < 0.01). Logistic regression analysis revealed that a history of alcohol consumption (OR = 2.795, P = 0.000), internet addiction (OR = 0.339, P = 0.000), and authoritative (OR = 1.912, P = 0.003) or neglectful (OR = 3.788, P = 0.000). Conclusion: The prevalence rate of Non-Suicidal Self-Injury (NSSI) behavior among middle school students is 17.83%. This behavior is negatively correlated with self-esteem levels and positively correlated with childhood trauma experiences. Female gender, educational attainment, smoking, alcohol abuse, internet addiction, as well as a combination of authoritative and neglectful parenting styles, represent independent risk factors for the occurrence of NSSI among adolescents.