目的 探讨初中生非自杀性自伤(NSSI)、抑郁情况,分析抑郁在行为抑制/激活系统(BIS/BAS)与NSSI之间的中介作用.方法 采用整群抽样法,于2022年6月选取山东省济宁市泗水县3所中学2900名初中生为研究对象,采用青少年自伤行为问卷、BIS/BAS量表和抑郁自评量表(SDS)进行问卷调查.采用Pearson相关分析各变量之间的相关性.采用SPSS Amos 24.0软件构建结构方程模型并进行中介效应检验.本研究共发放问卷2900份,回收有效问卷2429份,有效回收率为83.76％.结果 2429名初中生的NSSI年发生率为37.55％(912/2429),抑郁发生率为32.73％(795/2429).根据是否有过NSSI行为分为有NSSI组(n=912)和无NSSI组(n=1517).有NSSI组初中生的青少年自伤行为问卷得分为(33.01±21.24)分.有NSSI组初中生的BIS、BAS-愉悦追求、SDS得分分别为(11.08±2.93)、(7.15±2.58)、(53.17±10.67)分,高于无NSSI组的(10.16±3.15)、(6.52±2.55)、(43.16±9.77)分,差异有统计学意义(t=-7.312、-5.838、-23.098;P<0.001);有NSSI组初中生的BAS-奖赏反应得分为(11.64±2.53)分,低于无NSSI组的(12.16±2.24)分,差异有统计学意义(t=5.084,P<0.001).相关分析显示,有NSSI初中生的抑郁程度与NSSI严重程度、BIS敏感性、BAS-愉悦追求敏感性呈正相关(r=0.484、0.184、0.128;P<0.01);BAS-奖赏反应敏感性与NSSI严重程度、抑郁程度呈负相关(r=-0.203、-0.239;P<0.01).回归分析显示,抑郁对NSSI有正向影响(β=0.461,P<0.001),而BAS-奖赏反应对NSSI有负向影响(β=-0.093,P<0.01).结构方程模型结果显示,抑郁在BIS、BAS-愉悦追求与NSSI之间起完全中介作用,完全中介效应分别为0.121和0.104,占总效应的86.4％、72.7％;在BAS-奖赏反应与NSSI之间起部分中介作用,部分中介效应为-0.199,占总效应的58.2％.结论 初中生NSSI发生率较高,抑郁在BIS和BAS-愉悦追求与NSSI间起完全中介作用,在BAS-奖赏反应与NSSI之间起部分中介作用.

Background Non-suicidal self-injury (NSSI) is more common in adolescents and its occurrence may be influenced by personality traits. Children and adolescents are a high-risk group for NSSI. Although there are some studies on the prevalence of NSSI, however, there are fewer studies on the factors associated with the severity of NSSI and the specific causes of the influence of NSSI and personality traits. Methods Participants of this study were junior high school students enrolled in three different schools of a Chinese province. NSSI was evaluated using the Adolescents Self-Harm Scale and their personality traits were assessed using the Neuroticism Extraversion Openness Five-factor Inventory (NEO-FFI). Results 2376 junior high school students participated, and the annual incidence of NSSI was 37.1% (n=881). The mean age of the NSSI-detected individuals was 13.61 years (SD=1.017). Out of total number of detections, 56.6% (n=499) were female and 67.4% (n=594) were individuals who self-injured using multiple means. Hair pulling, scratching the skin, and whacking harder objects with the hand were the most common modes of NSSI, with incidences of 51.0%, 43.0%, and 42.8% respectively in the NSSI-detected population. There was a negative association between grade and NSSI severity (p < 0.05), and NSSI was more severe in females. The scores in the Neuroticism dimension were higher in the group with NSSI than in the group without NSSI, while the scores in the extraversion, openness, agreeableness and conscientiousness dimensions were lower than in the group without NSSI (p < 0.01). Neuroticism and openness were significantly positively correlated with NSSI severity, and extraversion, agreeableness, conscientiousness were significantly negatively correlated with NSSI severity (p < 0.01). Conclusion The severity of NSSI was relatively higher in lower grades among junior grades and females, and the number of self-injury using multiple means was significantly higher; hair pulling, skin scratching and whacking harder objects with hands were the most common NSSI modalities. Among the personality traits, for the incidence of NSSI, high neuroticism was a risk factor, and high extraversion, openness, agreeableness, and conscientiousness were protective factors. For the severity of NSSI, high neuroticism and high openness were risk factors, and high extraversion, high agreeableness, and high conscientiousness were protective factors.

目的 探讨山东省某三所县级中学初中生非自杀性自伤行为(NSSI)的发生率、严重程度与家庭环境的关系.方法 对山东省某县3所中学的2397名在校中学生,使用一般情况调查表、青少年自我伤害问卷和家庭环境量表中文版(FES-CV)调查NSSI的发生情况及该行为与家庭环境等因素的关系.结果 山东省某三所县级中学初中生NSSI的发生率为37.1％,不同性别、年级、成长环境NSSI发生率比较差异均有统计学意义(P<0.01).NSSI最常见的方式为拔头发,其次为用玻璃、小刀等划伤皮肤等,使用2种及以上自我伤害方式者占NSSI群体的68.2％,而使用单一手段进行NSSI的群体占31.8％.有NSSI初中生FES-CV亲密度、情感表达、独立性、成功性、知识性、娱乐性、道德宗教观、组织性评分均低于无NSSI初中生(P<0.01),矛盾性评分高于无NSSI初中生(P<0.01).FES-CV亲密度、情感表达、组织性均与NSSI严重程度呈负相关(P<0.01),家庭矛盾性与NSSI严重程度呈正相关(P<0.01).多元逐步回归分析结果示,女性、家庭文化性突出是NSSI程度严重的危险性因素(P<0.05),而家庭亲密度高、情感表达良好是NSSI程度严重的保护性因素(P<0.01).结论 山东省某三所县级中学初中生NSSI的发生率较高,且女生发生率高于男生,农村发生率高于城市.家庭因素对NSSI的发生及严重程度具有显著影响.

非自杀性自伤(NSSI)在青少年中发生率较高,是自杀未遂的高危因素之一.越来越多的研究表明,NSSI存在神经系统方面的改变,但有关磁共振成像技术(MRI)探讨NSSI神经生物学机制的研究尚无一致性结论.本文旨在对近年来有关NSSI磁共振成像文献进行梳理总结,为进一步深入研究提供参考.

目的 了解抑郁障碍青少年非自杀性自伤(NSSI)行为的特征以及其与生活事件、情绪症状的关系.方法 以112例青少年抑郁障碍患者为研究对象.使用青少年自我伤害问卷评估入组者NSSI情况并将其分为自伤组和无自伤组,使用自杀意念自评量表(SIOSS)评估自伤组自杀意念并将其分为伴自杀意念自伤组和不伴自杀意念自伤组.使用自制的一般情况调查表、青少年生活事件量表(ASLEC)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对各组进行信息采集.结果 在入组的112名抑郁障碍青少年中,NSSI检出率为83.0％,其中,伴自杀意念的NSSI和不伴自杀意念的NSSI占比分别为88.2％和11.8％.自伤组SAS、SDS评分以及ASLEC总分及人际关系因子分均高于无自伤组(P<0.05),伴自杀意念自伤组ASLEC人际关系因子分及SAS、SDS评分均高于不伴自杀意念自伤组(P<0.05).结论 抑郁障碍青少年NSSI检出率高,NSSI的发生与负性生活事件及焦虑、抑郁情绪有关.