Psychosocial Factors And Cognitive Function Of NSSI Behavior In Adolescent Patients With Depressive Disorder

Objective:1.Analyze the clinical characteristics and psychosocial factors of NSSI behavior in adolescent patients with depression;2.Combined with psychological assessment,behavioral detection and electrophysiological level,this study explored the cognitive function changes of adolescent patients with depression disorder with NSSI behavior.Methods:This research into mental health clinic in Shanxi Medical University First Hospital outpatient service meet the discharge standard of 51 patients with first-episode adolescent depression disorder(among which No self-inflicted suicide group 21 cases,NSSI group 18 cases,attempted suicide group(SA group,12 cases)and 24 cases of healthy controls(HC).The CRF case report form prepared by the research group was used to collect the general demographic data of the subjects.Hamilton anxiety(HAMA),Hamilton depression scale(HAMD-24),adolescent self-injury questionnaire and Beck Scale for Suicide Ideation-Chinese Version(BSI-CV)were used to evaluate clinical symptoms.The social psychological factors were assessed using the Secondary school shame scale,Childhood Trauma questionnaire(CTQ),Social support rating scale(SSS),Life event scale(LES),Eysenck personality questionnaire(EPQ),the Wong and Law EI scale(WLEIS),Mobile phone addiction index scale(MPAI),and Global pain assessment scale(GPS).The RBANS and the ERP were used to assess cognitive function.SPSS 22.0 software was used for data analysis.(1)?~2test was used for group comparison of categorical variables in general demographic data,and test or analysis of variance was used for continuous variables.(2)Analysis of variance was used to compare the scores of each scale and the indicators of ERP among the four groups;(3)Pearson correlation analysis was used for correlation analysis,followed by regression analysis using a general linear model,and the mediating effect of childhood maltreatment on shame and NSSI in the NSSI group was detected by the Process plug-in.P<0.05 was considered statistically significant.Results:(?)Comparison of general demographic data and clinical scale between three groups of adolescent patients with depression disorder and HC group The scores of HAMA and HAMD-24 in the four groups were statistically significant(p<0.01).The scores of the adolescent self-injury questionnaire and BSI-CV in the three groups were statistically significant(p<0.01).The remaining differences were not statistically significant(p>0.05).(?)Analysis of psychosocial factors of adolescent depressive disorder NSSI behavior 1.Evaluation results of EPQ:the scores of four subscales E,N,P and L in the four groups of participants were significantly higher than those in the HC group,with statistically significant differences(p<0.01).Further multiple comparisons showed that:compared with the No self-inflicted suicide group,the score of the E and N subscales of the NSSI group was higher,and the differences were statistically significant(p<0.01).Compared with the SA group,the scores of E,N and L subscales in the NSSI group were lower,and the differences were statistically significant(p<0.01);2.Evaluation results of CTQ:the scores of four factors of emotional abuse,physical abuse,emotional neglect and physical neglect in the four groups of participants were significantly higher than those in the HC group,and the differences between the groups were statistically significant(p<0.05).;3.Results of social environmental assessment:the differences in social support and negative event scores between the four groups were statistically significant(p<0.01).Further multiple comparisons showed that the NSSI group had higher negative event scores than the No self-inflicted suicide group(p<0.05).The score of NSSI group was lower than that of SA group,and the difference was also significant(p<0.01);4.MPAI,GPS,the Secondary school shame scale assessment result:No self-inflicted suicide group,NSSI group,SA group on the three scale scores were statistically significant difference between the groups(p<0.01);5.Social psychological factors associated with severity self-injury analysis:a group of NSSI CTQ,MPAI,SSS,shame,and self-injury severity and Pearson correlation analysis,according to the results of self-injury severity and CTQ(r=0.667,p<0.01),MPAI(r=0.728,p<0.01),shame(r=0.776,p<0.01)were significantly positive correlation,and SSS were significantly negative correlation(r=0.464,p<0.01);Shame was significantly positively correlated with CTQ(r=0.589,p<0.01)and MPAI(r=0.813,p<0.01),and negatively correlated with SSS(r=-0.491,p<0.01).SSS was negatively correlated with CTQ(r=-0.35,p<0.01)and MPAI(r=-0.494,p<0.01).There was a significant positive correlation between MPAI and CTQ(r=0.499,p<0.01).The results of regression analysis showed that both childhood maltreatment(t=2.67,p<0.05)and shame(t=2.475,p<0.05)had significant positive predictive effects on NSSI degree,while mobile phone dependence(t=1.45,p<0.05)and social support(t=-0.369,p<0.05)had no significant predictive effects on NSSI degree;6.Mediating effect:In the NSSI group,the mediating effect of childhood maltreatment on the relationship between shame and NSSI degree showed that the mediating effect of childhood maltreatment on the relationship between shame and NSSI degree was significant,with an effect value of 0.4465 and 95%CI(0.17,0.78),accounting for 24.4%of the total effect and 32.2%of the direct effect value;7.The WLEIS evaluation results showed that there was no statistically significant difference in the total score and the scores on the four subscales between the No self-inflicted suicide group,NSSI group and SA group(p>0.05).(?)Analysis of cognitive function characteristics of adolescent depressive disorder patients with NSSI behavior1.RBANS results showed that the differences in immediate memory,verbal function,attention,delayed memory,total score and standard score between the four groups were statistically significant(p<0.01);2.ERP test(P300?P50?N400?N170)results analysis:The latent period of N1,N2,P3a,P3b,P50,N400,and N170 at the Cz electrode points of the four groups showed statistically significant differences in P3a,P3b,P50,N400 and N170 amplitude and P50 inhibition(S1/S2)(p<0.05);Further analysis showed that compared with the No self-inflicted suicide group,,the latency period of P300 in the NSSI group was significantly prolonged and the amplitude of P300 was significantly reduced,with statistically significant differences(p<0.05).Compared with the SA group,the incubation period of P300 in the NSSI group was significantly shorter and the amplitude was significantly increased,with statistically significant differences(p<0.05).Conclusion:1.The main psychosocial factors related to the non-suicidal nssi behavior of adolescent depressive disorder patients include personality traits,childhood abuse,social support,negative sexual events,Internet addiction and sense of shame;2.Compared with depression patients without self-inflicted suicide behaviors,adolescent depression patients with NSSI behaviors had significantly impaired cognitive function,which was mainly manifested as memory loss,inattention,decreased executive ability and poor resource utilization.Compared with adolescent depressive disorder patients who attempted suicide,adolescent depressive disorder patients with NSSI behavior had less cognitive impairment.Compared with the healthy subjects,the adolescent patients with depression disorder have the characteristics of poor information screening ability,poor anti-interference ability,and impaired language cognitive function,face recognition,and processing ability.