Effects Of Metacognition,Emotional Intelligence And Rumination On Non-suicidal Self-injury In Adolescents With Depression

Objective:Non-suicidal self-injury（NSSI）as one of adolescent mental health problems,has attracted global concern.NSSI is very normal among adolescents with depression.This study aims to get to know the current situation of NSSI in adolescents with depression and to explore the path and extent of the influence which metacognition,emotional intelligence and rumination could have on NSSI behavior of depressed adolescents.Methods:According to DSM-5 diagnostic criteria for depression,120 adolescents with were included as subjects.According to the DSM-5 recommended diagnostic criteria for NSSI,the subjects were divided into NSSI group（n=65）and without NSSI group（n=55）.The general situation questionnaire,Hamilton Rating Scale For Depression（HAMD）,Hamilton Anxiety Scale（HAMA）,Adolescent Self-harm Scale,Emotional Intelligence Scale（EIS）,Ruminative Responses Scale（RRS）were used to evaluate every variable.Semi-structured interviews were conducted on the subjects.Nvivo software was used to organize and encode the interview data and the interview data were scored according to the Metacognition Assessment Scale（MAS-R2009）.SPSS 22.0 was used for data analysis.Results:1.Gender（χ²=4.82,p<0.05）,parental marital status（χ²=11.15,p<0.05）,Internet dependence（χ²=7.35,p<0.05）,and school violence（χ²=9.49,p<0.01）were significantly different between NSSI group and without NSSI group.2.HAMD in the group with NSSI was higher than that without NSSI,and the difference was marginal（p=0.06）.The results of covariance analysis using the total score of HAMD as a covariable showed that the total score of MAS in the group with NSSI was significantly lower than that in the group without NSSI after the effect of HAMD was eliminated(F_（1,117）=83.11,p<0.001);The total score of RRS in the group with NSSI was significantly higher than that without NSSI(F_（1,117）=13.74,p<0.001);There was no significant difference in the total score of EIS between the groups with and without NSSI(F_（1,117）=2.54,p=0.11>0.05).3.In the group with NSSI,there was a significant negative correlation between the total score of MAS and NSSI（r=-0.61,p<0.01）,was significantly positively correlated with the total score of RRS（r=0.62,p<0.01）,was significantly positively correlated with total HAMD scores（r=0.62,p<0.01）,was not correlated with the total score of EIS（p>0.05）,but was significantly negatively correlated with the emotional regulation of EIS subdimension（r=-0.44,p<0.01）.4.Path analysis results showed that depression,metacognition and rumination had direct effects on NSSI,and the standard path coefficients were 0.273,-0.277 and 0.336.Depression can also respectively by influencing the metacognitive（β=-0.588,p<0.001）and the ruminants thinking（β=0.368,p<0.01）,which affects NSSIConclusion:1.Compared to adolescents with depressive disorder without NSSI behavior,adolescents with NSSI behavior had lower metacognitive ability,lower ability to perceive and regulate emotions,and higher degree of rumination.2.Among adolescents with NSSI,the lower the metacognition score and the higher the depression and rumination score,the more serious the NSSI behavior may be.3.Metacognition,rumination and depression level can directly affect NSSI behavior of depressed adolescents.Depression can also affect NSSI behavior by affecting metacognition and rumination respectively.Poor metacognition promotes rumination and affects NSSI.