应佳丽, 苏亚娅, 喻彦, 林涛, 杨琛. 上海市某区初中生自伤行为发生现状及家庭影响因素[J]. 环境与职业医学, 2021, 38(1): 58-63. DOI: 10.13213/j.cnki.jeom.2021.20334
引用本文: 应佳丽, 苏亚娅, 喻彦, 林涛, 杨琛. 上海市某区初中生自伤行为发生现状及家庭影响因素[J]. 环境与职业医学, 2021, 38(1): 58-63. DOI: 10.13213/j.cnki.jeom.2021.20334
YING Jiali, SU Yaya, YU Yan, LIN Tao, YANG Chen. Prevalence of non-suicidal self-injury behavior and its association with family factors among middle school students in a Shanghai district[J]. Journal of Environmental and Occupational Medicine, 2021, 38(1): 58-63. DOI: 10.13213/j.cnki.jeom.2021.20334
Citation: YING Jiali, SU Yaya, YU Yan, LIN Tao, YANG Chen. Prevalence of non-suicidal self-injury behavior and its association with family factors among middle school students in a Shanghai district[J]. Journal of Environmental and Occupational Medicine, 2021, 38(1): 58-63. DOI: 10.13213/j.cnki.jeom.2021.20334

上海市某区初中生自伤行为发生现状及家庭影响因素

Prevalence of non-suicidal self-injury behavior and its association with family factors among middle school students in a Shanghai district

  • 摘要: 背景

    随着社会发展,传染性、营养不良性疾病在青少年中得到很好的控制,但心理与行为问题却越来越突出。自伤行为多发于初中时期,是危害初中生健康的严重公共卫生问题。

    目的

    了解上海市初中生自伤行为流行现状及其家庭影响因素。

    方法

    2019年9月采用分层整群随机抽样方法对上海市某区6所初中3 886名学生采用自编问卷和《青少年自我伤害问卷》进行现场匿名问卷调查,对不同人口社会学因素和家庭因素的初中生自伤行为发生情况采取χ2检验进行比较,将单因素分析有意义的变量纳入有序多分类logistic回归模型进行多因素分析。

    结果

    本次调查合计收到3 721份有效问卷。结果显示,最近一年内发生过自伤行为的人数为1 509人,自伤发生率为40.55%,男生自伤发生率为34.83%(660/1 895),女生为46.50%(849/1 826)。反复自伤人数为896人,占59.38%(896/1 509)。初中生排在第一、二位的故意自伤行为分别是故意拔自己头发,占13.95%,故意用手打墙和玻璃等较硬的东西占13.63%;第三、四位故意自伤行为是故意用玻璃、小刀等划伤自己的皮肤占9.75%,故意戳开伤口,阻止伤口的愈合占9.42%。对于进行故意自伤行为的原因,其中748人是为了发泄自己的情绪,占49.57%;257人是为了表达自己的愤怒,占17.03%;170人是为了惩罚自己,占11.27%;156人是为了从麻木和虚幻中逃脱出来,占10.34%;114人是为了从一些痛苦的或不好惩罚中解脱出来,占比7.55%。单因素结果显示不同性别、年级、户籍、居住地、自评身材满意度的学生自伤行为发生情况不同(P < 0.05)。有序多分类logistic回归分析结果显示男生,七年级、八年级,对身材满意,父母未离异是自伤行为的保护因素,OR及95%CI分别是0.609(0.533~0.696)、0.658(0.556~0.778)、0.834(0.700~0.994)、0.656(0.573~0.749)和0.786(0.633~0.976)(P < 0.05);母亲饮酒,父母经常争吵、偶尔争吵,父母经常责骂、偶尔责骂是自伤行为的危险因素,OR及95%CI分别是1.471(1.208~1.791)、2.212(1.682~2.910)、1.292(1.116~1.495)、3.089(2.465~3.870)和1.414(1.180~1.693)(P < 0.05)。

    结论

    上海市某区初中生自伤发生率较高,女性,母亲饮酒,有不良的父母关系和不良的家庭教养方式的学生更容易发生自伤行为。

     

    Abstract: Background

    With the development of society, infectious and malnutrition diseases in adolescents are under good control, but psychological and behavioral problems are more and more prominent. Non-suicidal self-injury (NSSI) behavior is a serious public health problem, and is more likely to occur in adolescence.

    Objective

    This study is designed to investigate the prevalence of NSSI behavior and its association with family factors among middle school students in Shanghai.

    Methods

    By stratified cluster random sampling method, 3 886 students from six middle school in a Shanghai district were selected and invited to finish a self-designed questionnaire and the Adolescence Self-injury Questionnaire in September 2019. Chi-square test was used to compare the incidence of NSSI behavior among the students with different sociodemographic characteristics and family factors, and ordered multi-class logistic regression analysis was used to analyze the variables significant in the univariate analysis.

    Results

    A total of 3 721 valid questionnaires were received in this survey. The results showed that 1 509 students reported NSSI behavior in the past year, and the incidence rate of NSSI was 40.55%; the boys' incidence rate was 34.83% (660/1 895), and the girls' was 46.50% (849/1 826). Among them, 896 students reported repeated NSSI behavior, accounting for 59.38% (896/1 509). The first ranking NSSI behavior of the middle school students was pulling out their hair, accounting for 13.95%; the second, hitting hard things such as walls and glasses intentionally, accounting for 13.63%; the third, purposefully scratching their skin with a piece of glass or a knife, accounting for 9.75%; and the fourth, deliberately picking at or interfering with wound healing, accounting for 9.42%. Regarding reasons for NSSI behavior, 748 students (49.57%) used self-injury to vent their emotions; 257 (17.03%) to express their anger; 170 (11.27%) to punish themselves; 156 (10.34%) to distract themselves from numbness and illusion; and 114 (7.55%) to relief from painful emotions or punishment. The chi-square test results showed that the NSSI behavior incidence varied among the students of different gender, grade, household registration, place of residence, physical self-satisfaction groups (P < 0.05). The results of ordered multi-class logistic regression analysis showed that boys, the students in grade 7 and grade 8, who were satisfied with their bodies, whose parents stayed married were associated with lower risks of NSSI, and the ORs and 95% CIs were 0.609 (0.533-0.696), 0.658 (0.556-0.778), 0.834 (0.700-0.994), 0.656 (0.573-0.749), and 0.786 (0.633-0.976), respectively (P < 0.05); the students whose mothers consumed alcohol, whose parents quarreled frequently or occasionally, and whose parents scolded them frequently or occasionally were associated with higher risks of NSSI, and the ORs and 95% CIs were 1.471 (1.208-1.791), 2.212 (1.682-2.910), 1.292 (1.116-1.495), 3.089 (2.465-3.870), and 1.414 (1.180-1.693), respectively (P < 0.05).

    Conclusion

    The incidence of NSSI among middle school students in the studied district of Shanghai is high. Students who are girls, have a drinking mother, suffer a discordant parent relationship, and experience unfavorable parental education are more likely to commit NSSI behavior.

     

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