A Study On The Characteristics And Influencing Factors Of Non-suicidal Self-injury Behaviors In Adolescents With Depression

Objective:To investigate the characteristics and influencing factors of non-suicidal self-Injury in adolescents with depression,in order to provide evidence for the identification and prevention of non-suicidal self-Injury in adolescents with depression.Methods:A total of 226 adolescent patients with depression who met the admission criteria were enrolled as outpatients or inpatients in Hunan Brain Hospital from October 2019 to December 2020.According to the diagnostic criteria of NSSI of DSM-5,the patients were divided into two groups:NSSI group(n=90)or non-NSSI group(n=136).Demographic data were collected using a self-made general situation questionnaire,the patients'depression severity and symptoms were measured with the17-item Hamilton rating scale for depression(HAMD-17),the Ottawa NSSI scale was used to investigate the behavior characteristics of NSSI,the Childhood trauma questionnaire(CTQ),Adolescent self-rating life events checklist(ASLEC),Simplified coping style questionnaire(SCSQ),Social support scale(SSS),and Barratt impulsivity scale(BIS-11)were used to assess psychosocial factors.Chi-square test,independent sample t test and logistic regression analysis were adopted for statistical analysis.Results:1.The detection rate of NSSI in adolescents with depression was 39.82%,and the age of initial NSSI ranged from 10 to 18 years old,with an average age of(13.30±1.74)years old.There was no statistical significance in age,gender,only child or household registration type,the scores of HAMD-17 between non-NSSI group and NSSI group(P>0.05).The forearm and wrist(40%)were the most frequently injured body parts,followed by the hand(33.33%).81.11%of the NSSI patients had more than one self-injury body part.The most common way of self-Injury is cutting(40%),followed by hitting(15.56%).There is a statistically significant differences in the most common way of NSSI between male and female(X~2=17.798,P<0.05).Men tend to hit,while women tend to cut.51.11%of the patients considered for less than 5minutes before NSSI.2.The scores of BIS-11 total score,motor impulse factor,attention impulse factor and unplanned impulse factor in the NSSI group were all higher than those in the non-NSSI group,and the difference was statistically significant(P<0.05).3.The scores of emotional abuse,physical abuse,emotional neglect,and physical neglect in the NSSI group were all higher than those in the non-NSSI group,and the difference was statistically significant(P<0.05).4.The scores of interpersonal factors,learning stress factors,punishment factors,loss factors,health adaptation factors and other factors in the NSSI group were all higher than those in the non-NSSI group,the differences were statistically significant(P<0.05).5.The total scores of social support scale and the degree of support utilization in the NSSI group were lower than those in the non-NSSI group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the scores of objective support and subjective support between NSSI group and non-NSSI group(P>0.05).6.The scores of positive coping in the group with NSSI was significantly lower than those in the group without NSSI;The scores of negative coping factors in the group with NSSI was significantly higher than those in the group without NSSI,and the differences were statistically significant(P<0.05).7.Logistic regression analysis showed that emotional abuse,interpersonal relationship,learning pressure,negative coping,total impulse score and support utilization were the influencing factors of NSSI in adolescent patients with depression.Conclusion:1.Adolescent patients with depression have a high incidence of NSSI behaviors,and the age of 12-15 years old is the age of high incidence of NSSI.The most common injury site is"lower arm and wrist",and the most commonly used way of NSSI is"cutting".2.NSSI behaviors of adolescent with depression are related to impulsivity,childhood abuse and adverse life events,social support,coping style and other factors.High learning pressure,negative coping style,poor interpersonal relationship,emotional abuse and high impulsivity are the risk factors for NSSI behavior in adolescents with depression,and good utilization of social support is the protective factor.