门诊青少年非自杀性自伤行为的潜在剖面分析

Latent profile analysis of non-suicidal self-injury behaviors in adolescent outpatients

中文关键词:  青少年  非自杀性自伤  潜在剖面分析

英文关键词:Adolescents  Non-suicidal self-injury  Latent profile analysis

中文摘要:

      背景 既往关于青少年非自杀性自伤（NSSI）亚组的研究多基于社区或学校样本，针对临床样本的探讨尚显不足。然而，精准识别NSSI青少年的具体亚型，对于优化医疗资源配置至关重要。目的 探索门诊NSSI青少年群体的亚组分型，为青少年NSSI行为的干预提供参考。方法 于2021年5月—2022年4月选取在福建省内6所医院的精神科或心理科门诊就诊的、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）NSSI诊断标准的青少年192例。采用青少年非自杀性自伤行为评定问卷（ANSAQ）、童年创伤问卷（CTQ）、抑郁-焦虑-压力量表简体中文版（DASS-21）以及情绪调节困难量表（DERS）进行评定。使用Mplus 8.0进行潜在剖面分析。结果 共192例NSSI青少年完成本研究。门诊NSSI青少年群体可以分为三类：轻度自伤组［50例（26.04%）］、情绪失调自伤组［81例（42.19%）］以及重度自伤组［61例（31.77%）］。三组CTQ总评分、DASS-21总评分以及DERS总评分比较，差异均有统计学意义（F=8.058、51.414、48.742，P均<0.01）。重度自伤组CTQ评分、DASS-21评分以及DERS评分均高于轻度自伤组和情绪失调自伤组，差异均有统计学意义（P均<0.05）；情绪失调自伤组DASS-21评分和DERS评分均高于轻度自伤组，差异均有统计学意义（P均<0.05）。结论 门诊青少年NSSI行为存在3个潜在剖面，即轻度自伤组、情绪失调自伤组与重度自伤组。

英文摘要:

      Background Previous studies on subgroups of adolescent non-suicidal self-injury （NSSI） behaviors have predominantly focused on community and school-based samples， with limited research on clinical samples. The precise identification of clinically distinct NSSI subgroups in adolescents is critical for optimizing medical resource allocation.Objective To explore the subgroups of NSSI in adolescent outpatients， and to provide references for intervening of NSSI behaviors.Methods From May 2021 to April 2022， 192 adolescents who met the NSSI diagnostic criteria as outlined in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） were recruited from psychiatry or psychology clinics at 6 hospitals in Fujian Province. Participants were assessed using the Adolescent Non-suicidal Self-injury Assessment Questionnaire （ANSAQ）， the Childhood Trauma Questionnaire （CTQ）， the Depression Anxiety Stress Scale-21 item（DASS-21） and the Difficulties in Emotion Regulation Scale （DERS）. Latent profile analysis was conducted using Mplus 8.0.Results A total of 192 adolescents with NSSI behaviors completed the study， and the analysis yielded three subgroups of self-injurers： the mild self-injury group （50 cases， 26.04%）， the emotional disorder group （81 cases， 42.19%）， and the severe self-injury group （61 cases， 31.77%）. There were significant differences in the total scores of CTQ， DASS-21 and DERS among the three groups （F=8.058， 51.414， 48.742， P<0.01）. The severe self-injury group exhibited significantly higher scores in CTQ， DASS-21 and DERS when compared to both the mild self-injury group and the emotional disorder group （P<0.05）. Moreover， the emotional disorder group also reported notably higher DASS-21 and DERS scores in comparison to the mild self-injury group （P<0.05）.Conclusion Clinical studies on adolescent outpatients engaging in NSSI behaviors reveal three distinct typological profiles， mild self-injury， emotional disorder-related self-injury， and severe self-injury. ［Funded by Fujian Social Science Planning Project （number， FJ2019B173）］