As society progresses and people's lives become more and more stressful,depression is becoming an important factor affecting people's health and ischaracterized by a low age. Adolescent depression has become one of the mostimportant disorders in psychiatric hospitals. Moreover, the prevalence of non-suicidalself-injury (NSSI) in depressed adolescent is high. Non-suicidal self-injury not onlycauses serious psychological trauma and physical injury to adolescents, but alsobrings great grief to families. However, it is still unclear that the current status ofNSSI in depressed adolescents in mainland China and the psychological mechanismsbehind, and the treatment of this behavior in psychiatric hospitals is still in its infancyand lacks theoretical support. In order to alleviate this situation and provide assistancefor the mental health of depressed adolescents, three studies were conducted in thisstudy.
The purpose of Study 1 was to understand the current prevalence of NSSI amongdepressed adolescents in mainland China and the factors influencing them.Participants were drawn from 710 depressed adolescents from 17 psychiatric hospitalsin mainland China who were diagnosed by psychiatrists as having depression, bipolardisorder depressive episode, and depressive states according to the DSM-5. In thisstudy, the Functional Assessment of Self-Mutilation (FASM) was used to measureNSSI, and participants were divided into NSSI and non NSSI groups based on thepresence or absence of NSSI within 12 months. The results showed that there weresignificant differences between the two groups of participants in terms of age, genderand years of education. Rumination scores and stress scores were significantly andpositively correlated with NSSI scores. Social support (high social support) andgender (man) emerged as protective factors for NSSI. Among them, family support insocial support and symptom rumination in rumination became influential factors forNSSI.
The purpose of study 2 was to investigate the mechanisms of the role ofpsychological variables in NSSI and to develop a psychological model. Participantswere the same as in Study 1. We conducted a pathway analysis of stress on NSSI andexplored the role of rumination and social support. The results showed that ruminationmediated the effect of stress on NSSI and social support moderated the effect of stresson NSSI. Low to moderate levels of social support significantly moderated the effectsof stress on NSSI. Family support can have a direct effect on NSSI.
The purpose of Study 3 was to explore family factors that influence theemergence of NSSI in depressed adolescents. Participants including depressedadolescent and their parent. The study was conducted with depressed adolescentsfocused on measuring the severity of NSSI, parental marital satisfaction, parent-childrelationship, and family functioning. The results showed that parental maritalsatisfaction and parent-child relationship were negatively associated with children'sNSSI. Family functioning was a protective factor for NSSI, and the degree of familyharmony affected NSSI.
In summary, this study concludes that (1) the current prevalence of NSSI amongdepressed adolescents in mainland China is 87.1%, and social support, gender, andrumination are influential factors of NSSI; (2) stress can influence NSSI throughrumination, and social support can moderate the effect of stress on NSSI; (3) thedegree of family function influences adolescent's NSSI.
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