Non-suicidal self-injury and professional psychological help-seeking among Chinese left-behind children: prevalence and influencing factors

Abstract

Background Non-suicidal self-injury (NSSI) is a risk factor for suicide. This study aimed to investigate the prevalence of NSSI and professional psychological help-seeking status and influencing factors among left-behind children (LBC) in China. Methods We implemented a population-based cross-sectional study in participants aged 10–18 years. Sociodemographic characteristics, NSSI, help-seeking status and coping style were measured by self-reported questionnaires. A total of 16,866 valid questionnaires were collected, including 6096 LBC. Binary logistic regression models were used to analyze the factors influencing NSSI and professional psychological help-seeking. Results The incidence of NSSI among LBC was 4.6%, significantly higher than that of non-left-behind children (NLBC). This incidence was higher among girls. Moreover, 53.9% of LBC with NSSI did not receive any treatment and only 22.0% sought professional psychological help. LBC often adopt emotion-oriented coping styles, specifically, those with NSSI. LBC with NSSI who seek professional help tend to adopt problem-oriented coping styles. Logistic regression analysis revealed that girls, learning stage, single-parent, remarried families, patience, and emotional venting were risk factors for NSSI in LBC, while problem-solving and social support seeking were protective factors. Moreover, problem-solving was also a predictor for seeking professional psychological help, patience will prevent it. Limitations This was an online survey. Conclusions The prevalence of NSSI in LBC is high. Gender, grade, family structure, and coping style affect the occurrence of NSSI among LBC. Only a few LBC with NSSI seek professional psychological help, while the coping style will affect the help-seeking behavior.

Protective and risk factors associated with problem behaviors among disadvantaged children and adolescents in rural China during the COVID-19 pandemic

“…Notably, over 64% of the sample were left-behind children (i.e., children being left in the original villages by their migrant parents) who might rely on smartphone to communicate with parents, and thus, increase the use of smartphone amid the pandemic. In addition, Chen et al’s (2020) study investigated children's problem behaviors immediately after the outbreak (i.e., four weeks after the implementation of stay-at-home mandates), whereas the present study examined behavioral changes amid the pandemic for a longer period of time (approximately four months after the regional lockdown), which extends the literature (e.g., Hou et al, 2021; Yong et al, 2023) by highlighting the relatively prolonged impact of the pandemic on disadvantaged children and adolescents’ problematic behaviors.…”

“…Especially among individuals who were previously exposed to traumatic experiences, they may be more vulnerable to the detrimental effects of the pandemic (Holmes et al, 2020). Empirical research corroborates this finding, observing that individuals having prior exposure to adversities were at a higher risk of psychological distress (Fernández et al, 2020;Mazza et al, 2020) and non-suicidal self-injury behaviors (Plener, 2021;Yong et al, 2023) amid the pandemic. Moreover, stress experiences related to the pandemic may aggregate children and adolescents' maladaptation to pandemic situations (Ye et al, 2022).…”

“…A total score for each construct was computed; based on the suggested cut-offs (Walker et al, 1999), each type of adverse experience was dichotomized (0 = not abused/neglected, 1 = abused/neglected). Besides, since prior research has observed the detrimental impact of left-behind experiences for children and adolescents’ behavioral health (e.g., higher incidence of non-suicidal self-injury behaviors, greater smartphone addiction, more screen time; Fellmeth et al, 2018; He et al, 2021; Yong et al, 2023; Zhen et al, 2020), we included experiences of being left-behind as one type of prior adversities. Participants were asked if one or both of their parents had separated from them for at least six months (0 = not left-behind, 1 = left-behind).…”

“…It is noteworthy that the COVID-19 pandemic and associated preventive measures had significantly impacted the living experiences (e.g., disrupted student learning) and well-being of people from rural China (Wang et al, 2021;Zhao et al, 2023). Specifically, prior research has observed high prevalence of mental health problems (e.g., depressive symptoms, suicidal ideation and attempts) among adolescents in rural China during the COVID-19 pandemic (Hou et al, 2020;Hou et al, 2021;Yong et al, 2023). Examining changes in problem behaviors among disadvantaged children and adolescents in rural China, the present study adds novelty to the extant literature that primarily focuses on their mental health symptoms impacted under the pandemic conditions.…”