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目的分析童年期不良经历(adverse childhood experiences, ACEs)暴露模式和视屏时间与中学生非自杀性自伤行为(non-suicidal self-injury behaviors, NSSI)的关联。方法 2017年11月—2018年1月,采用分层整群抽样的方法,从深圳、贵阳、南昌、郑州四个地区共抽取29所中学的14 500名中学生(男生7347名,女生7153名;初中生7247名,高中生7253名;城市7619名,农村6881名),使用儿童期虐待问卷、家庭功能不全问卷、NSSI评定问卷以及视屏时间条目进行调查,采用潜类别分析评价ACEs暴露模式,利用多因素Logistic回归模型分析ACEs不同暴露模式和不同水平视屏时间及其联合作用与NSSI的关联。结果潜类别分析显示,ACEs可分为高ACEs(6.3%)、高虐待忽视(21.4%)、高忽视(45.5%)和低ACEs(26.8%)4种暴露模式。各暴露模式中,相对低ACEs,高ACEs(OR=4.65, 95%CI 3.73～5.80)、高虐待忽视(OR=3.43,95%CI 2.91～4.06)和高忽视(OR=1.31,95%CI 1.11～1.55)暴露模式均与NSSI发生风险增加有关(P<0.001)。学习日(OR=1.72,95%CI 1.42～2.08)和周末(OR=1.42,95%CI 1.27～1.60)高水平视屏时间均与NSSI发生风险增加相关(P<0.001)。随着ACEs暴露程度和视屏时间水平的增加,NSSI的检出风险呈增高趋势(P<0.05)。结论 ACEs高暴露模式以及高视屏时间与中学生NSSI的增加相关,减少ACEs暴露及控制视屏时间有益于中学生NSSI的防控。
Abstract：OBJECTIVE The aim of this paper is to understand the relationship between patterns of adverse childhood experiences(ACEs), screen time and non-suicidal self-injury behaviors(NSSI) among middle school students. METHODS Stratified cluster sampling method was used to select 14 500 middle school students(7347 boys and 7153 girls; 7247 junior high school students and 7253 senior high school students; 7619 urban students and 6881 rural students) from Shenzhen, Guiyang, Nanchang and Zhengzhou Cities. Questionnaire surveys were conducted using the child abuse questionnaire, household dysfunction questionnaire, non-suicidal self-injury behavior questionnaire and screen time items. The latent class analysis was used to evaluate the ACEs exposure patterns, and multivariable logistic regressions was used to analyze the association between patterns of ACEs, screen time levels and their combined effects with NSSI. RESULTS Latent class analysis indicated four distinct patterns of ACE exposure: highly ACEs group(6.3%), highly abuse and neglect group(21.4%), lowly ACEs group(26.8%), highly neglect group(45.5%).Those in highly ACEs(OR=4.65, 95%CI 3.73-5.80), highly abuse and neglect(OR=3.43, 95%CI 2.91-4.06) and highly neglect(OR=1.31, 95%CI 1.11-1.55) group had significantly higher risk of NSSI compared with those in lowly ACEs group(P<0.001). In study days(OR=1.72,95%CI 1.42-2.08) and weekends(OR=1.42,95%CI 1.27-1.60), high screen time were associated with increased rate of NSSI(P<0.01). There showed a trend toward increased risk of NSSI with increasing ACEs exposure and screen time level(P<0.05). CONCLUSION High ACEs exposure patterns and high screen time are associated with increased rate of NSSI. Reducing ACEs exposure and controlling screen time is beneficial to the prevention and control of NSSI in middle school students.
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基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2022.01.004
中图分类号:G444
引用信息:
[1]李书琴,徐慧琼,高鑫,等.四城市中学生童年期不良经历暴露模式和视屏时间与非自杀性自伤行为的关联[J].卫生研究,2022,51(01):18-23+31.DOI:10.19813/j.cnki.weishengyanjiu.2022.01.004.
基金信息:
国家自然科学基金(No.82073576,81773453)
2022-01-30
2022-01-30