Advertisement

Deliberate self-harm behaviors in Chinese adolescents and young adults

  • Yu-Hui Wan
  • Chuan-Lai Hu
  • Jia-Hu Hao
  • Ying Sun
  • Fang-Biao Tao
Original Contribution

Abstract

The aim of this paper was to describe the prevalence of deliberate self-harm (DSH) and to determine the socio-demographic, behavioral, and psychological correlates of DSH behaviors in Chinese adolescents and young adults in a representative sample of the general population. The data were obtained from an epidemiologic study involving adolescents and young adults from junior and senior schools and colleges located in eight provinces of China. A total of 17,622 cases were retained for analysis. The relationship between the explanatory variables with self-harm was analyzed using a Pearson χ 2 test and a multinomial logistic regression model. A total of 3,001 (17.0%) students reported that they had harmed themselves deliberately in the past 12 months. The act of DSH occurring 1 and >2 times accounted for 4.2% (742) and 12.8% (2,259) of all respondents, respectively. The most frequently reported form of DSH was self-hitting. If the reference category was No DSH, the findings indicated that family composition, father’s education, perceived family economic status, cigarette use, perceived body image, and higher scores in depression scales were important concomitants of repeat-incidents of DSH. The students, in western areas, who were younger, reported that having unhealthy weight control behaviors, and alcohol use had a higher risk for both types of DSH. Regarding students of age 15–18 years perceived body image (too fat), having unhealthy weight control behaviors or a high level of depression symptoms demonstrated an elevated risk for repeat-incident DSH when single-incident DSH was used as the reference category, whereas the students in middle area reported family composition (both parents), education of the father (less than college) or alcohol use had a decreased risk for repeat-incident DSH. The results of this study suggest that both types of DSH are associated with other wide-ranging problems in the students’ lives. Despite their common features, these phenomena also differed from each other. It is necessary to investigate the possible neurobiologic underpinnings of DSH within a longitudinal study to enhance the knowledge of this behavior.

Keywords

Self-harm Adolescents Young adults Mental health 

Notes

Acknowledgments

The authors are indebted to the research assistants and specialists for their generous assistance in the survey conducted in Harbin, Bejing, Taiyuan, Chongqing, Guiyang, Wuhan, Shaoxing, and Guangzhou. Sincere thanks also go to the head teachers, teachers, and children of the schools who participated in the study for their help and cooperation. The study was supported by China 863 National High Technology Research and Development Project (2006AA02Z427).

Conflict of interest

None.

References

  1. 1.
    Gratz KL (2003) Risk factors for and functions of deliberate self-harm: an empirical and conceptual review. Clin Psychol Sci Pract 10:192–205CrossRefGoogle Scholar
  2. 2.
    Klonsky ED (2007) The functions of deliberate self-injury: a review of the evidence. Clin Psychol Rev 27:226–239PubMedCrossRefGoogle Scholar
  3. 3.
    Rodham K, Hawton K, Evans E (2004) Reasons for deliberate self-harm: comparison of self-poisoners and self-cutters in a community sample of adolescents. J Am Acad Child Adolesc Psychiatry 43:80–87PubMedCrossRefGoogle Scholar
  4. 4.
    Fortune SA, Hawton K (2005) Deliberate harm in children and adolescents: a research update. Curr Opin Psychiatry 18:401–406PubMedCrossRefGoogle Scholar
  5. 5.
    Tick NT, van der Ende J, Verhulst FC (2008) Ten-year increase in service use in the Dutch population. Eur Child Adolesc Psychiatry 17:373–380PubMedCrossRefGoogle Scholar
  6. 6.
    Hawton K, Rodham K, Evans E et al (2002) Deliberate self-harm in adolescents: self report survey in schools in England. BMJ 325:1207–1211PubMedCrossRefGoogle Scholar
  7. 7.
    De Leo D, Heller TS (2004) Who are the kids who self-harm? An Australian perceived school survey. Med J Aust 181:140–144PubMedGoogle Scholar
  8. 8.
    Laukkanen E, Rissanen ML, Honkalampi K et al (2009) The prevalence of self-cutting and other self-harm among 13- to 18-year-old Finnish adolescents. Soc Psychiatry Psychiatr Epidemiol 44:23–28PubMedCrossRefGoogle Scholar
  9. 9.
    Brunner R, Parzer P, Haffner J et al (2007) Prevalence and psychological correlates of occasional and repetitive deliberate self-harm in adolescents. Arch Pediatr Adolesc Med 161:641–649PubMedCrossRefGoogle Scholar
  10. 10.
    Tuisku V, Pelkonen M, Karlsson L et al (2006) Suicidal ideation, deliberate self-harm behavior and suicide attempts among adolescent outpatients with depressive mood disorders and comorbid axis I disorders. Eur Child Adolesc Psychiatry 15:199–206PubMedCrossRefGoogle Scholar
  11. 11.
    Nixon MK, Cloutier P, Jansson SM (2008) Nonsuicidal self-harm in youth: a population-based survey. CMAJ 178:306–312PubMedGoogle Scholar
  12. 12.
    Sansone RA, Levitt JL (2002) Self-harm behaviors among those with eating disorders: an overview. Eating Disord 10:205–213CrossRefGoogle Scholar
  13. 13.
    Ross S, Heath NL (2003) Two models of adolescent self-mutilation. Suicide Life Threat Behav 33:277–287PubMedCrossRefGoogle Scholar
  14. 14.
    Byrne S, Morgan S, Fitzpatrick C et al (2008) Deliberate self-harm in children and adolescents: a qualitative study exploring the needs of parents and carers. Clin Child Psychol Psychiatry 13:493–504PubMedCrossRefGoogle Scholar
  15. 15.
    Whitlock J, Eckenrode J, Silverman D (2006) Self-injurious behaviors in a college population. Pediatrics 117:1939–1948PubMedCrossRefGoogle Scholar
  16. 16.
    Zhang Anhui, Tao Fangbiao, Su Puyu (2008) Investigation on self-harm and the related factors in children and adolescents. Chin J Public Health 24:1303–1305Google Scholar
  17. 17.
    Eaton DK, Kann L, Kinchen S et al (2010) Youth risk behavior surveillance—United States, 2009. MMWR Surveill Summ 59:1–142PubMedGoogle Scholar
  18. 18.
    Zung WW (1965) A self-rating depression scale. Arch Gen Psychiatry 12:63–70PubMedGoogle Scholar
  19. 19.
    Zung WW (1971) A rating instrument for anxiety disorders. Psychosomatics 12:371–379PubMedGoogle Scholar
  20. 20.
    Morey C, Corcoran P, Arensman E et al (2008) The prevalence of perceived deliberate self-harm in Irish adolescents. BMC Public Health 8:79PubMedCrossRefGoogle Scholar
  21. 21.
    Nock MK, Prinstein MJ (2004) A functional approach to the assessment of self-mutilative behavior. J Consult Clin Psychol 72:885–890PubMedCrossRefGoogle Scholar
  22. 22.
    National Suicide Research Foundation (NSRF) (2007) National registry of deliberate self harm, Annual report, 2005 Cork, NSRFGoogle Scholar
  23. 23.
    Laukkanen E, Rissanen ML, Honkalampi K et al (2009) The prevalence of self-cutting and other self-harm among 13- to 18-year-old Finnish adolescents. Soc Psychiatry Psychiatr Epidemiol 44:23–28PubMedCrossRefGoogle Scholar
  24. 24.
    Yates TM (2004) The developmental psychopathology of self-injurious behavior: compensatory regulation in posttraumatic adaptation. Clin Psychol Rev 24:35–74PubMedCrossRefGoogle Scholar
  25. 25.
    Shin YM, Chung YK, Lim KY et al (2009) Childhood predictors of deliberate self-harm behavior and suicide ideation in Korean adolescents: a prospective population-based follow-up study. J Korean Med Sci 24:215–222PubMedCrossRefGoogle Scholar
  26. 26.
    Nock MK, Prinstein MJ (2005) Contextual features and behavioral functions of self-mutilation among adolescents. J Abnorm Psychol 114:140–146PubMedCrossRefGoogle Scholar
  27. 27.
    Nixon MK, Cloutier PF, Aggarwal S (2002) Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. J Am Acad Child Adolesc Psychiatry 41:1333–1341PubMedCrossRefGoogle Scholar
  28. 28.
    Patton GC, Hemphill SA, Beyers JM et al (2007) Pubertal stage and deliberate self-harm in adolescents. J Am Acad Child Adolesc Psychiatry 46:508–514PubMedCrossRefGoogle Scholar
  29. 29.
    Hintikka J, Tolmunen T, Rissanen ML et al (2009) Mental disorders in self-cutting adolescents. J Adolesc Health 44:464–467PubMedCrossRefGoogle Scholar
  30. 30.
    Mahadevan S, Hawton K, Casey D (2010) Deliberate self-harm in Oxford university students, 1993–2005: a descriptive and case-control study. Soc Psychiatry Psychiatr Epidemiol 45:211–219PubMedCrossRefGoogle Scholar
  31. 31.
    Patton GC, Hemphill SA, Beyers JM et al (2007) Pubertal stage and deliberate self-harm in adolescents. J Am Acad Child Adolesc Psychiatry 46:508–514PubMedCrossRefGoogle Scholar
  32. 32.
    Olfson M, Gameroff MJ, Marcus SC et al (2005) National trends in hospitalization of youth with intentional self-inflicted injuries. Am J Psychiatry 162:1328–1335PubMedCrossRefGoogle Scholar
  33. 33.
    Kessler RC, Berglund P, Borges G et al (2005) Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. JAMA 293:2487–2495PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Yu-Hui Wan
    • 1
  • Chuan-Lai Hu
    • 1
  • Jia-Hu Hao
    • 1
  • Ying Sun
    • 1
  • Fang-Biao Tao
    • 1
  1. 1.Anhui Provincial Key Laboratory of Population Health and Aristogenics, Department of Maternal, Child and Adolescent Health, School of Public HealthAnhui Medical UniversityHefeiChina

Personalised recommendations