Abstract
PurposeNon-suicidal self-injury (NSSI) in adolescent has drawn increasing attention because it is associated with subsequent depression, drug abuse, anxiety disorders, and suicide. In the present study, we aimed to estimate the prevalence of non-suicidal self-injury (NSSI) in a school-based sample of Chinese adolescents and to explore the association between aggression and NSSI.MethodsThis study was part of a nationwide study on aggression among adolescents in urban areas of China. A sample of 2907 school students including 1436 boys and 1471 girls were randomly selected in Guangdong Province, with their age ranging from 10 to 18 years old. NSSI, aggression, emotional management and other factors were measured by self-administrated questionnaire. Multinomial logistic regression was used to estimate the association between aggression and NSSI, after adjustment for participants’ emotional management, and other potential confounding variables.ResultsThe one year self-reported prevalence of NSSI was 33.6%. Of them, 21.7% engaged in ‘minor NSSI’, 11.9% in ‘moderate/severe NSSI’. 96.9% of self-injuries engaged in one to five different types of NSSI in the past year. Hostility, verbal and indirect aggression was significantly associated with self-reported NSSI after adjusting for other potential factors both in ‘minor NSSI’ and ‘moderate/severe NSSI’. Hostility, verbal and indirect aggression was significantly associated with greater risk of ‘minor NSSI’ and ‘moderate/severe NSSI’ in those who had poor emotional management ability.ConclusionThese findings highlight a high prevalence of NSSI and indicate the importance of hostility, verbal and indirect aggression as potentially risk factor for NSSI among Chinese adolescents.
Highlights
Non-suicidal self injury (NSSI) is not an illness but a behavior often enacted by individuals with the intention of physically harming themselves [1]
Girls were more likely to be engaged in NSSI than boys ( x2 = 9.408, p = 0.009)
No significance on indirect aggression and hostility was found between boys and girls (x2 = 0.002, p = 0.966; x2 = 1.585, p = 0.208); while significance on physical aggression, verbal aggression, anger and hostility were found (x2 = 42.911, p,0.001; x2 = 18.012, p,0.001; x2 = 7.739, p = 0.005)
Summary
Non-suicidal self injury (NSSI) is not an illness but a behavior often enacted by individuals with the intention of physically harming themselves [1]. Hawton et al conducted an anonymous self-report survey in 41 schools in England and they reported a lifetime prevalence of 13.2% among 15,16 year olds in 2000/2001 [5]. A study conducted in Sweden reported a lifetime prevalence of 17.1% among 17 years olds [6]. In the United States, lifetime prevalence of NSSI generally ranged from 12%,20.2% in secondary school children and 12%,20% in late adolescent and young adults [7,8]. Daniel et al conducted a survey among 3328 secondary school students in Hong Kong and they reported that 32.7% of the students had at least one form of NSSI during the previous 1 year [11]. Many factors contributed to those inconsistencies prevalence of NSSI, such as sampling, assessment instruments, time frames, and different classification system for NSSI, and etc, while there is a consensus that adolescence is a risky period in which NSSI may occur [12]
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