Abstract
Non-suicidal self-injury (NSSI) is prevalent among adolescents. Low health literacy (HL) and problematic mobile phone use (PMPU) are risk factors of NSSI. But so far, no study has examined the interactive role of HL and PMPU on NSSI. In this context, the present study aimed to examine the interactions of HL and PMPU and their impact on NSSI in a school-based sample of Chinese adolescents. A total of 22,628 junior and high school students (10,990 males and 11,638 females) were enrolled in this study. The outcomes were self-reported HL, PMPU and NSSI. Analyses were conducted with chi-square tests and logistic regression models. The prevalence of NSSI was 32.1%. Low HL and PMPU were significantly associated with NSSI independently (ORlow HL = 1.886, 95% CI = 1.723–2.065, ORPMPU = 2.062, 95% CI = 1.934–2.199). Interaction analysis indicated that low HL and PMPU were interactively associated with increased risks of NSSI (OR = 2.617, 95% CI = 2.375–2.884). In all, our findings indicate that HL and PMPU are associated with NSSI independently and interactively. The intervention programs of NSSI should consider the adolescents HL levels and PMPU.
Highlights
Non-suicidal self-injury (NSSI) refers to the intentional self-inflicted destruction of body tissue without suicidal intention and for purposes not socially sanctioned
We found that middle school students reported a higher rate of NSSI than high school, that means, NSSI was more likely to happen in early adolescence, which is similar to other studies [4,32]
The multivariate logistic regression analyses indicated that students with low health literacy (HL) were likely to experience NSSI, and the association was enhanced by problematic mobile phone use (PMPU). This result was consistent with the inter-behavioral fields of developmental psychology [26,27]. These findings indicated that the role of HL and PMPU should be noted in Chinese adolescents
Summary
Non-suicidal self-injury (NSSI) refers to the intentional self-inflicted destruction of body tissue without suicidal intention and for purposes not socially sanctioned. Existing evidences found that NSSI increases the risk of suicide leading to death, and NSSI usually first emerges during early adolescence [2,3,4]. Adolescents appear to engage in NSSI at higher rate than adults [5]. A study in Spanish suggested approximately more than half of adolescents reported a history of NSSI at least once in the past 12 months, and 32.2% had serve NSSI behaviors [6]. Swannell et al estimated that the international rate of NSSI among adolescents was 17.2% [7]. A meta-analysis based on Chinese adolescents reported that the pooled prevalence of NSSI was 22.37% [8]. NSSI is still highly prevalent among adolescents and is a serious public health problem [9,10]
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