The Effect And Path Analysis Of Coping Styles, Emotional And Behavioral Difficulties On Non-suicidal Self-injury Among Middle School Students

Objective:firstly,to analyze the characteristics of non-suicidal self injury(NSSI),emotional and behavioral difficulties and coping style in the middle school students.Secondly,to explore the relationship between coping style,emotional and behavioral difficulties and NSSI.Lastly,to analyze the mediating effect of emotional and behavioral difficulties between coping styles and NSSI,and to provide a theoretical basis for reducing NSSI among the middle school students.Methods:the students were investigated in three middle schools in Jiangxi Province,who were in grade one and grade two in both junior and senior middle school.Taken junior grade three and senior three students were not easy to cooperate in the examination stage into account,so they were excluded.The three secondary schools were the middle school attached to Nanchang university,Linchuan No.2middle school and Chongren No.2 middle school,all of which included junior middle school and senior middle school.A total of 7500 students from 3 middle schools were investigated by general situation questionnaire,self-injury judgment item,coping style questionnaire for middle school students and strengths and difficulties questionnaire.Statistical methods included traditional single factor analysis and binary logistic regression.Meanwhile,structural equation modeling was applied to analyze the mediating effect.All the data were processed by SPSS22.0 and Amos21.0 respectively.Results:(1)2403 students have carried out NSSI among the surveyed 7129middle school students in the past year.the prevalence was 33.7%,which in girls was higher than that in boys(P<0.001).The prevalence of NSSI was 33.8%in junior school students,which in the city was higher than that in rural areas(P<0.001).The prevalence of NSSI was 33.7%in senior high school students,and there was no difference between urban and rural areas(?~2=0.1,P=0.729).(2)The prevalence of NSSI was higher in those who were scold and beaten frequently and had heavy study stress than those who were not both in junior and senior high school students.(3)The self-injurers usually use more than one method,and each of whom take 2.3(5493/2403)methods in average."Bitten yourself"and"Dug or scratched yourself"were the most commonly used method.Among the self-injures,boys preferred to take the way of"banged head on the wall","Pulled your hair out","Burned yourselves with a cigarette,fire or hot water"and"Swallowed or drunk some inedible thing",while girls preferred to take the way of"Bitten yourself","Dug or scratched yourself"and"Cut or pierce yourself with a knife or sharp edge"(all P<0.001).“Bitten yourself”is the most common used method in both boys and girls.Junior school students preferred to use"banged head on the wall"and"Swallowed or drunk some inedible thing"than senior high school students(all P<0.01).(4)The scores of problem solving,reasonable explanation,endurance,escape,venting emotion and fantasy/denial in high school students were higher than those in junior school students(all P<0.001).the scores of seeking social support and venting emotion in boys was lower than that in girls and the score of endurance was higher than that in girls both in junior and senior high school students(all P<0.05).For junior school students,problem solving(OR=0.975,95%CI:0.955~0.996,P<0.001)could reduce the occurrence of NSSI,and venting emotion(OR=1.070,95%CI:1.035~1.106,P<0.001)and fantasy/denial(OR=1.048,95%CI:1.021~1.076,P<0.001)could increase the occurrence of NSSI.For senior high school students,endurance(OR=1.047,95%CI:1.009~1.087,P<0.001),venting emotion(OR=1.038,95%CI:1.002~1.074,P<0.001)and fantasy/denial(OR=1.063,95%CI:1.033~1.093,P<0.001)would increase the occurrence of NSSI.(5)On emotional and behavioral problems,the scores of emotional symptoms,hyperactivity/inattention and pro-social behavior in junior school students were lower,while the scores of conduct problems and peer relationship problems were higher than those than those in senior high school students(P<0.05).The scores of conduct and peer relationship problems in boys were higher than that in girls,while the scores of emotional symptoms and pro-social behavior were lower than that in girls in junior school students(all P<0.05).The scores of conduct and peer relationship problems in boys were higher than that in girls,while the scores of emotional symptoms,total difficulties and pro-social behavior were lower than that in girls in senior high school students(all P<0.05).For junior middle school students,the students with emotional symptoms(OR=1.128,95%CI:1.087~1.171,P<0.001),conduct problems(OR=1.077,95%CI:1.021~1.135,P=0.006)were more likely to carry out NSSI.For senior high school students,the students with emotional symptoms(OR=1.166,95%CI:1.1119~1.215,P<0.001)and hyperactivity/inattention(OR=1.083,95%CI:1.035~1.133,P=0.001)were more likely to carry out NSSI.(6)Emotional and behavioral problems played a partial mediating effect between emotion-focused coping and NSSI.Conclusion:(1)The prevalence of NSSI was high in middle school students.which in girls was higher than that in boys.(2)Frequent elder scolding,elders'corporal punishment and heavy learning burden are risk factors of NSSI in middle school students.(3)The self-injurers take 2.3 methods in average."Bitten yourself"and"Dug or scratched yourself"were the most commonly used method.(4)There are differences in both grade and gender in coping style and emotional and behavioral problems among middle school students.(5)On the coping style,seeking social support is the protective factor of NSSI.Endurance,venting emotion and fantasy/denial are the risk factors of NSSI.On the emotional and behavioral problems,emotional symptoms,conduct problems and hyperactivity/inattention are the risk factors of NSSI.(6)Emotional and behavioral problems play a mediating effect between emotion-focused coping and NSSI.(7)Non-suicidal self-injury and mental health in middle school students should be paid attention to by the family,schools and society.The efforts should be made to improve the coping skills in middle school students in order to reduce emotional and behavioral problems,and reduce ultimately the risk of NSSI among middle school students.