Abstract
BackgroundSelf-harm (SH) is an emerging problem among Chinese adolescents. The present study aimed to measure the prevalence of SH behaviours and to explore the relationship between childhood adversity and different SH subtypes among Chinese adolescents.MethodsA total of 5726 middle school students were randomly selected in three cities of Anhui province, China, using a stratified cluster sampling method. SH was categorized into five subtypes (highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm). Multivariate logistic regression was used to explore the relationships between childhood adversity and different subtypes of adolescent SH.ResultsThe prevalence rates of highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm were 6.1, 20.4, 32.0, 20.0 and 23.0%, respectively. Childhood sexual abuse and physical peer victimization were associated with each SH subtype with adjusted odds ratios (AORs) ranging from 1.23 to 1.76. Highly lethal self-harm was associated with childhood physical peer victimization, sexual abuse, emotional abuse, and emotional neglect. The less lethal SH subtypes (i.e., less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm) were associated with childhood peer victimization, family life stress event scores and childhood sexual abuse.ConclusionsA high prevalence of SH exists among Chinese adolescents. The association of childhood adversity with SH merits serious attention in both future research and preventive interventions.
Highlights
Self-harm (SH) is an emerging problem among Chinese adolescents
Based on previous studies [1, 11], five subtypes of SH were proposed according to the severity of the negative impact of SH: highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage, and psychological self-harm
Types of less lethal self-harm with visible tissue damage and self-harm without visible tissue damage were consistent with current reports for non-suicidal SH, including non-suicidal self-injury (NSSI) and deliberate self-harm (DSH); these are actions with a low likelihood of death
Summary
Self-harm (SH) is an emerging problem among Chinese adolescents. The present study aimed to measure the prevalence of SH behaviours and to explore the relationship between childhood adversity and different SH subtypes among Chinese adolescents. Some researchers have argued that the specific method of selfinjury should be considered first rather than the intent behind the self-injurious behaviours when studying these behaviours among adolescents [1]. The International Classification of Diseases 10th Revision (ICD-10) defined intentional self-harm as purposely self-inflicted poisoning or injury, including suicide (attempted). The definition of NSSI in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) was intentional self-inflicted injury performed with the expectation of physical harm without suicidal intent [10]. Both the ICD-10 and DSM-5 classified SH as the result of obvious damage to an individual’s own self, whereas implicit forms of self-harmful behaviours were neglected.
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