Resilience mediates the association between self-harm and suicidal ideation in Chinese left-behind children

Yuanyuan Xiao,Hailiang Ran,Fang Liu,Wenhang Deng,Die Fang,Yusan Che,Ahouanse Roland Donald

doi:10.1186/s12889-021-12153-1

Abstract

BackgroundA significant association between self-harm (SH) and suicide ideation (SI) has been found in Chinese left-behind children (LBC). Existing literature suggests that resilience might be a mediator in this association. However, this hypothesis has not been effectively discussed. The major aim of our study is to analyze the possible mediation of resilience in SH-SI association in Chinese LBC.MethodsA population-based clustering sampling survey of 2619 LBC was conducted in southwestern China Yunnan province. Self-developed structured questionnaire was used to collect relevant information. Univariate and multivariate Logistic regression models were applied to estimate the associations between SH and SI, resilience and SI, and SH and resilience. Path analysis was adopted to measure the mediation of resilience, as well as its 5 dimensions, in the association between SH and SI. A subgroup analysis was further done to explore the mediation of resilience in the associations between SH severity and SI, SH repetition and SI, among self-harmed LBC.ResultsCompared with LBC who reported no SH behaviors, the odds ratio (OR) for SI was 3.37 (95% CI: 2.63–4.31) among self-harmed LBC. Based on the path model, resilience significantly mediated a quarter of the total association between SH and SI. Among the 5 dimensions of resilience, emotion regulation, interpersonal assistance, and family support were the strongest mediators. Subgroup analysis revealed that, the mediation of resilience was only significant for SH severity and SI.ConclusionsResilience played as a prominent mediator in SH-SI association among Chinese LBC. Resilience-centered intervention measures could be considered to reduce suicidal risk of this disadvantageous group.

Highlights

A significant association between self-harm (SH) and suicide ideation (SI) has been found in Chinese left-behind children (LBC)
With this regard, understanding key factors involved in the intimate association between SH and SI is crucial for suicide prevention in Chinese LBC
A total of 555 participants were identified as suicidal ideators, with the estimated lifetime SI prevalence of 21.20%

Summary

Introduction

A significant association between self-harm (SH) and suicide ideation (SI) has been found in Chinese left-behind children (LBC). The most widely accepted theory of suicidality stresses on its continuum development, which starts from suicidal ideation (SI), through suicide plan and suicide attempt, ends at suicide completion [12]. From this perspective, the presence of SI can be seemed the harbinger of imminent suicidal behaviors. We found that SH and SI were prominently associated with each other in Chinese LBC: among LBC who had SH experience, 33.6% reported SI, about 3-fold of which in LBC who did not have SH history (11.4%) [13]. With this regard, understanding key factors involved in the intimate association between SH and SI is crucial for suicide prevention in Chinese LBC

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