Direct self-injurious behavior (DSIB) has become an important focus due to its perniciousness and perplexity. Little is known about its prevalence and correlative factors in Chinese adolescents, including how data may differ according to gender. A multicenter, multistage stratified cluster random sampling was used to examine the previous 12-month prevalence of DSIB, as well as the possible correlates of demographics, risky behaviors, suicidality, and psychosocial factors associated with DSIB in a school-based sample of 11,880 students (49.5 % boys and 50.5 % girls). Approximately 30 % of the adolescents in the sample reported at least one incident of DSIB in the past 12-month period. After controlling for demographic variables, analyses of the independent relationships of DSIB with risky behaviors, suicidality, and psychosocial factors were conducted for each gender. Smoking, binge drinking, running away from home, suicide ideation, suicide plans, positive affect, and physical symptoms were identified as common factors associated with DSIB for both genders in the final model. In addition, truancy, fighting, physical inactivity, motor impulsiveness, and depressed affect were found to be related to DSIB in boys, whereas suicide attempts and somatic complaints were found to be related to DSIB in girls. Separation anxiety and social anxiety associated negatively with DSIB in boys and girls, respectively. DSIB was not found to independently relate to attention impulsiveness, non-planned impulsiveness, self-esteem, or harm avoidance in either genders. DSIB was prevalent in Chinese adolescents. Programs intended to promote physical and mental health in adolescents should take into account gender differences in DSIB-associated factors, including risky behaviors, suicidality, and psychosocial factors.
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The authors would like to thank the following people for their work in participant recruitment and data collection at the study sites used: Zhengyan Jiang (Zhejiang University), Jing Liu (Peking University), Yuan Wang and Aining Guo (Ningxia Medical University), Wenbing Gao (Chinese Academy of Sciences), Yanqing Tang (China Medical University), Jin Jing (Sun Yat-Sen University), Wenqing Fu (Suzhou University), Yi Huang (Sichuan University), and Wei Hong (Peking University). We also thank all of the students and schools for their participation and support.
Compliance with Ethical Standards
This study was supported by grants from the National Key Technologies Research and Development Program of the 11th 5-year plan of China (No. 2009BAI77B02) and the construct program of the key discipline in Hunan Province.
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
The signed Informed consent was obtained from the subjects or their parents/legal guardians if the subjects were younger than 18 years old in the study.
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