| Objective:Non-suicidal self-injury（NSSI）has become a major public health problem on psychosomatic damage in adolescents.The DSM-5 calls for more attention to NSSI by regarding it as a separate diagnostic item of"condition for further research".The purpose of this study was to compare the general demographic data,attachment and related psychosocial factors（life events,coping styles and social support）between adolescents with NSSI and with depressive disorder,and to explore the interaction between attachment dimensions and these factors in NSSI group.Methods:From September to December 2019,patients aged 12 to 18 years old were randomly enrolled from the psychological counseling Clinic and the inpatient department of psychosomatic medicine in Chaohu Hospital affiliated to Anhui Medical University.At the same time,students were randomly selected from three classes in Chaohu No.2 Middle school as healthy controls.A total of 112 adolescents with NSSI,97 adolescents with depressive disorder and 102 healthy adolescents were confirmed.A general demographic questionnaire,the Experiences in Close Relationships inventory（ECR）,the Adolescent Self-rating Life Event Checklist（ASLEC）,the Coping Style Questionnaire（CSQ）and the Social Support Rating Scale（SSRS）were used.Statistical analysis were performed using SPSS 26.0 and PROCESS V3.4.1.X~2test was used for categorical variables,and Kruskal-Wallis test and Mann-Whitney U test were used for continuous variables to perform descriptive statistics or pin-pair comparison of the three groups.p<0.05 was considered statistically significant.Furthermore,the Spearman correlations between psychological factors in NSSI group was further analyzed,and the mediation effect model with attachment dimensions as independent variable were proposed.Results:（1）The mean age of NSSI group was（15.44±1.46）years old,meeting the criteria for risky age,which was not significantly different from that of depressive disorder group and healthy controls.The proportion of females in NSSI group was significantly higher（85.7%）than other groups.（2）Multiple comparisons were made between the general demographic data and psychological factors of the three groups,and there are significant differences on parental relationship,the frequency of parental cold war,the frequency of parental fighting,whether parental contradictions affected their children,parental marriage situation and family economic conditions and all psychological factors（p<0.05）.（3）Comparison of NSSI group and depression disorder group showed parental relationship,the frequency of parental cold war,parental marriage situation,attachment avoidance,attachment anxiety,interpersonal relationship,punishment,maladaptation,other life events,problem-solving and self-blame have existed significant differences（p<0.05）.（4）Comparison of NSSI group and healthy controls showed parental relationship,the frequency of parental cold war,the frequency of parental fighting,parental contradictions which affected their children,parental marriage situation and family economic conditions,attachment avoidance,attachment anxiety,interpersonal relationship,learning pressure,punishment,maladaptation,other life events,problem-solving and self-blame,help-seeking,fantasy,avoidance,objective support,subjective support and support utilization have existed significant differences（p<0.05）.（5）In NSSI group,there was a significant negative correlation between attachment avoidance and problem-solving（r=-0.35,p<0.05）.After PROCESS modeling,interpersonal relationship made an indirect mediating effect between attachment anxiety and self-blame.Conclusion:Compared with patients with depressive disorder,the adolescent with NSSI showed psychological heterogeneity with lack of parental role and cold family atmosphere,by the way,they exposed to obvious attachment insecurity,more negative life events pressure and to adopt immature coping styles,but social support rating did not exist differences. |
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