The Association Between College Maladjustment And Persistent Non-Suicidal Self-Injury Among College Students:the Mediating Effects Of Depression

Objective:This study was conducted to investigate the prevalence and persistent situation of non-suicidal self-injury（NSSI）among college students,to explore the relationship between college maladjustment and persistent non-suicidal self-injury and the mediating effect of depression,so as to provide scientific evidence for prevention and intervention of persistent non-suicidal self-injury among college students.Methods:Totally 1988 freshmen from two comprehensive universities in Wuhan were chosen by cluster sampling technics.This study was divided into two stages.The demographic characteristics,NSSI behavior and college adjustment status were investigated in the baseline survey,and 1876 questionnaires were left after deleting these invalid questionnaires.The effective rate of questionnaires was 94.37%.One year later,1876 college students were followed up,and the NSSI behavior,college adjustment and depression were investigated,1670 valid questionnaires were collected.The t-test,chi-square test and logistic regression analysis were used to explore the risk factors of persistent NSSI.Mediating effect analysis were performed to explore the relationship among college maladjustment,depression and persistent NSSI among college students.Results:1.A total of 1876 freshmen were included in baseline study,947 were males and 929 were females;at the baseline stage,340 of them reported NSSI behavior and the prevalence was 18.20%;1670 college students were included at follow-up survey,however the prevalence of NSSI was 10.50%,which was significantly lower than baseline reported（χ²=40.88,P<0.05）.What’s more,the incidence of NSSI among boys was higher than girls（X²=6.55,P<0.05）at follow-up study.College students who reported NSSI were usually used the ways of“hit oneself”and“bite oneself”,and the main purpose of NSSI were“alleviate psychological tension and painful feelings”,“punish or warn oneself”and“divert attention”.2.In order to explore the occurrence of persistent NSSI and its risk factors,304college students who complicated both in two stage study with NSSI at baseline were selected and divided into persistent and non-persistent NSSI groups.The results showed that the prevalence of persistent NSSI was 27.63%.Univariate analysis found that college maladjustment was closely related to persistent NSSI behavior:The prevalence of persistent NSSI among college students with maladjustment was higher（35.65%vs.22.75%,P<0.05）;the higher the frequency and type of NSSI at baseline,the higher rate of persistent NSSI(χ²_frequency=10.48,P<0.05;χ² _type=9.96,P<0.05).Multivariate logistic analysis showed that after controlling for the confounding factors of gender,age and baseline characteristics of NSSI,there was still a correlation between college maladjustment and persistent NSSI（OR=1.92,95%CI=1.08³.43）.3.After controlling for depression,college maladjustment was not associated with persistent NSSI,depression fully mediated the relationship between college maladjustment and persistent NSSI;Depression partially mediated the relationship between frequency of NSSI at baseline and persistent NSSI.Conclusions:The prevalence of non-suicidal self-injury among college students was high,and the prevalence of NSSI at baseline was higher than follow-up survey.The relationship between college maladjustment and persistent NSSI was fully mediated by depression among college students.