Associations between coping styles, gender, their interaction and non-suicidal self-injury among middle school students in rural west China: A multicentre cross-sectional study

Abstract

BackgroundTo investigate the association between coping styles, gender, their interactions and non-suicidal self-injurious (NSSI) behaviors among middle school students in rural western China under COVID-19.MethodsA multicentre cross-sectional study method was used to conduct an online survey of 8,361 students from 23 middle schools in the northern Sichuan region by clustering sampling, using the General Information Questionnaire, the Ottawa Self-Injury Inventory, and the Coping Style Scale for Middle School Students.ResultsThe past year prevalence of NSSI among middle school students in rural west China was 5.7%. The differences in scores between those with and without NSSI on all dimensions of coping styles were statistically significant (p < 0.001). Multivariate logistic regression analysis revealed that vocational high school (OR = 1.67), girls (OR = 2.5), single parent with divorced parents (OR = 1.89), remarriage with divorced parents (OR = 1.81), and tolerance (OR = 1.17), venting emotions (OR = 1.15) and fantasy/denial (OR = 1.07) in coping styles may increase the risk of NSSI among middle school students, while problem solving (OR = 0.9) and seeking social support (OR = 0.9) among coping styles may reduce the risk of NSSI among middle school students. The interaction results show that gender has a moderating role in the process of endurance, avoidance, venting of emotions, and fantasy/denial influencing non-suicidal self-injury in middle school students.ConclusionThere is an association between coping styles and self-injury among middle school students in rural areas in western China, with gender playing a moderating role. Active attention should be paid to students' coping styles and encouraging them to adopt positive coping styles as well as avoid negative coping styles, especially in the case of girls, which can help prevent self-injury.

The Effect of Bullying Victimization on Adolescent Non-Suicidal Self-Injury: The Mediating Roles of Alexithymia and Self-Esteem

“…Furthermore, adolescents attending high middle school had a significantly higher incidence of NSSI than junior middle school students, which was consistent with the previous findings. 78 , 79 This could be because senior high school students may be confronted with greater academic pressures and more stressful life events compared to junior middle school students. 80 More importantly, the result of binary logistic regressions also found that bullying victimization exposure, high levels of alexithymia, and low self-esteem all significantly enhance the likelihood of NSSI among adolescents.…”

Cognitive impairment and factors influencing depression in adolescents with suicidal and self-injury behaviors: a cross-sectional study

“…This finding indicates that SAs and NSSI may be accompanied by altered performance in working memory and EF. There were significantly more females than males in this study, which is common in clinical practice [ 62 , 63 ]. However, males die by suicide more frequently than females [ 62 , 64 ] but females more often have SAs [ 62 ] and NSSI [ 63 ].…”

“…There were significantly more females than males in this study, which is common in clinical practice [ 62 , 63 ]. However, males die by suicide more frequently than females [ 62 , 64 ] but females more often have SAs [ 62 ] and NSSI [ 63 ]. Neuroimaging studies suggest that abnormalities in the amygdala and orbitofrontal cortex are strongly associated with SAs in patients with MDD [ 65 ].…”

The Link between Sleep Insufficiency and Self-Injury among In-School Adolescents: Findings from a Cross-Sectional Survey of Multi-Type Schools in Huangpu District of Shanghai, China

“…When adjusted for all the possible factors, being at a key school other than at an ordinary or vocational school was a protective factor for conducting self-injury. It might be because students in key schools have a higher self-efficacy and self-esteem than their counterparts in ordinary and vocational schools [ 27 ]. The “healthy worker effect” could also explain such a phenomenon: the “cleverest ones” being selected by key schools are usually those who are mindful, saying, having a high attention to and awareness of what is occurring in the present; thus, few of them would use self-injury as an improper way to regulate this emotion [ 18 ].…”