初中生自我伤害行为危险因素分析

摘要

目的：调查大连市1463名在校初中生的自伤发生率及其相关危险因素。方法以符合CCMD-3蓄意自我伤害诊断标准的75名初中生为研究组（自伤组），匹配正常者为对照组。方法采用一般问卷、青少年生活事件量表（ASLEC）、父母养育方式评价量表（EMBU）和应付方式问卷（CSA）进行调查。结果自伤检出率为5．4％，其中男生2．8％，女生2．6％，性别间差异无显著性意义（χ2＝1．636， P＝0．441）。13岁为蓄意自伤高发年龄，各年龄组间差异明显（χ2＝20．827， P＝0．000）。 ASLEC量表中的人际关系、学习压力因子，组间差异明显（ t1-2＝2．082，4．033；P1-2＝0．039，0．000），“学习压力”是初中生主要压力源；EMBU量表中父母“情感温暖”在自伤组得分显著低于正常组（父亲t＝-3．839， P＝0．000；母亲t＝-4．007， P＝0．000）；CSA量表的自责、退避、幻想因子分组间差异显著（自责t＝3，577，P＝0．000；退避t＝4．294， P＝0．000；幻想t＝2．589， P＝0．011）。二元Logistic回归分析揭示初中生自伤行为危险因素包括：自责、退避、合理化、学习压力和被惩罚；自伤行为的危险因素存在性别差异。结论初中生自伤行为发生率较高，主要危险因素是学习压力、父母关爱不足、人际交往问题。%Objective To investigate self-harm incidence and risk factors in junior high school students in Dalian city . Methods 75 junior high school students , who met the DSH diagnosis standards of CCMD -3, were recruited in the study group.Control group included matched normal students .The study used General Screening Questionnaire , Adolescent Life Event Scale (ASLEC), EMBU (Egma Minnen av Bardndosnauppforstran ) and Coping Style Questionnaire (CSA).Re-sults The rate of self-harm behavior was 5.4%in the junior high school students with 2.8%in boys and 2.6%in girls. There was no significant difference between genders (χ2 =1.636, P=0.441).In all subjects, 13 year-old was the high-est danger age for self -harm behavior.There was significant difference among different age (χ2 =20.827,P=0.000).In the ASLEC scale score, there were significant differences on interpersonal relations'and study pressure'(t1-2 =2.082, 4.033;P1-2 =0.039, 0.000).In EMBU questionnaire, parent's Emotional Warmth'was the major risk factor and was signif-icantly lower in the self-harm group (Father t=-3.839, P=0.000 and Mother t=-4.007, P=0.000).In the CSA, significant differences were found among Self -accusation, Retreat, and Fantasy factors (Self-accusation t=3.577, P=0.000;Retreat t=4.294, P=0.000;Fantasy t=2.589, P=0.011).Binary Logistic regression analysis revealed 5 risk factors for self-harm including Self -accusation, Retreat, Rationalization, Study pressure and punishment .Gender differ-ence was observed in the risk factors .Conclusion Self-harm behavior often occurs in junior high school students .The main risks include study pressure , lack of parent's warmth, and interpersonal relation problems .