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Menarche and menstrual problems are associated with non-suicidal self-injury in adolescent girls

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Abstract

Menstrual problems and non-suicidal self-injury (NSSI) are common in adolescent girls. This study examined whether onset of menstruation and menstrual problems were related to NSSI in Chinese female adolescents. A total of 5696 adolescent girls participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort (SABHC) study in Shandong, China. A structured questionnaire was used to ask about participants’ lifetime and last-year NSSI, age at menarche, menstrual cycle interval, menstrual flow length, menstrual irregularity, period pain, body weight and height, and demographics. Impulsivity was assessed by the Eysenck I7 impulsiveness scale. Internalizing and externalizing problems were measured by the Youth Self-Report of Child Behavior Checklist. The mean age of the sample was 15.0 years (SD = 1.4). The prevalence of lifetime and last year NSSI were 28.1% and 21.4% in Chinese adolescent girls. After adjusting for adolescent and family covariates (age, body mass index, impulsivity, internalizing and externalizing problems, paternal education, and family economic status), onset of menstruation was significantly associated with increased risk of lifetime NSSI (OR = 1.62, 95%CI = 1.20–2.20) and last year NSSI (OR = 1.92, 95%CI = 1.37–2.67). Among adolescent girls who had menarche, often irregular menstruation and period pain were significantly and independently associated with lifetime NSSI (OR = 1.36, 95%CI = 1.03–1.79; OR = 1.29, 95%CI = 1.05–1.58) and last year NSSI (OR = 1.46, 95%CI = 1.07–1.98; OR = 1.29, 95%CI = 1.03–1.61). Our findings suggest that onset of menarche, irregular periods, and period pain appear to be associated with increased risk of NSSI. These findings highlight the importance of menstruation hygiene education and treatment of menstrual problems to reduce the risk of NSSI among adolescent girls.

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Acknowledgements

The authors would like to thank staffs at the Yanggu County Center for Disease Control and Prevention, Lijin County Center for Disease Control and Prevention, and Zoucheng City Center for Disease Control and Prevention, Shandong Province, China, and all participating school teachers for their help with data collection and all students for their voluntarily participating in the study.

Funding

This work was funded by the National Natural Science Foundation of China (Grant number 81573233) and Shandong University School of Public Health Third Level Discipline Infrastructure Project Fund (Grant number 2017-08).

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Authors and Affiliations

  1. Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, No. 44, Wenhuaxi Rd, Lixia Dist, Jinan, 250012, China

    Xianchen Liu, Zhen-Zhen Liu & Cun-Xian Jia

  2. School of Psychology, South China Normal University, Shipai, Guangzhou, 510631, China

    Xianchen Liu & Fang Fan

  3. The University of Tennessee Health Science Center, Memphis, TN, 38163, USA

    Xianchen Liu

  4. Kelin Health Research, Montgomery, NJ, 08502, USA

    Xianchen Liu

Authors
  1. Xianchen Liu
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  2. Zhen-Zhen Liu
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  4. Cun-Xian Jia
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Corresponding authors

Correspondence to Xianchen Liu or Cun-Xian Jia.

Ethics declarations

We obtained permission to conduct the study from the principals in the target schools and informed consent from participants in the target classes before the survey. Participants were asked to get permission from their parents to participate in the survey. The study was approved by the research ethics committee of Shandong University School of Public Health and target schools.

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Liu, X., Liu, ZZ., Fan, F. et al. Menarche and menstrual problems are associated with non-suicidal self-injury in adolescent girls. Arch Womens Ment Health 21, 649–656 (2018). https://doi.org/10.1007/s00737-018-0861-y

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  • DOI: https://doi.org/10.1007/s00737-018-0861-y

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