累积家庭风险对大学生非自杀性自伤行为的影响：有调节的链式中介作用

Effect of cumulative family risk on non-suicidal self-injury behaviors in college students： a moderated chain mediation model

中文关键词:  累积家庭风险  情绪调节困难  抑郁  非自杀性自伤行为  链式中介效应

英文关键词:Cumulative family risk  Emotional regulation difficulties  Depression  Non-suicidal self-injury behaviors  Chain mediating effect

中文摘要:

      背景 非自杀性自伤（NSSI）行为已成为全球性公共卫生问题。我国大学生NSSI行为检出率为9.8%~13.53%。整合理论模型指出，远端家庭风险因素通过情绪调节机制影响NSSI行为，但现有研究多聚焦单一家庭风险因素，关于累积家庭风险与NSSI行为的关系及其作用路径尚不清楚。目的 探讨累积家庭风险对大学生NSSI行为的影响，分析情绪调节困难与抑郁的链式中介作用，并检验性别的调节效应，为针对性干预大学生的NSSI行为提供参考。方法 于2024年3月1日，采用整群抽样法选取黑龙江省两所高校共518名大学生。使用中文版童年创伤问卷（CTQ）、情绪调节困难量表（DERS）、患者健康问卷抑郁量表（PHQ-9）及青少年自我伤害问卷进行评定。采用Logistic回归分析考查累积家庭风险各因素对大学生NSSI行为的影响。采用Process 4.1中的模型6检验情绪调节困难与抑郁在累积家庭风险与NSSI行之间的链式中介效应，采用模型83分析性别对“累积家庭风险→情绪调节困难”的调节作用。结果 共475名（91.70%）大学生完成有效问卷调查。Logistic回归分析结果显示，童年期虐待（OR=2.561，95% CI：1.566~2.561）、非双亲家庭（OR=2.108，95% CI：1.102~4.029）以及留守经历（OR=2.356，95% CI：1.021~5.439）是大学生NSSI行为的危险因素。累积家庭风险可正向预测NSSI行为（β=0.345，95% CI：1.059~4.286，P<0.01），且可以通过情绪调节困难（β=0.136，95% CI：0.882~4.681，P<0.01）和抑郁（β=0.160，95% CI：0.316~1.073，P<0.01）的链式中介作用间接影响NSSI行为；性别在累积家庭风险与情绪调节困难之间起调节作用（β=0.103，95% CI：1.567~8.316，P<0.01），累积家庭风险可以预测女性大学生情绪调节困难（β=0.374，95% CI：0.099~0.084，P<0.01）。结论 累积家庭风险既能直接影响大学生NSSI行为，也可以通过情绪调节困难和抑郁间接影响NSSI行为。该中介模型中的“累积家庭风险→情绪调节困难”路径受性别的调节。

英文摘要:

      Background Non-suicidal self-injury （NSSI） behaviors have become a serious global public health issue.The detection rate of NSSI behaviors among college students in China ranges from 9.8% to 13.53%. Integrated theoretical models suggest that distal family risk factors influence NSSI behaviors through emotional regulation mechanisms. However， existing researches have predominantly focused on single family risks， leaving the relationship between cumulative family risks and NSSI behaviors， as well as the underlying pathways， remain unclear.Objective To explore the effects of cumulative family risk on NSSI behaviors among college students， analyze the chain mediating roles of emotional regulation difficulties and depression， and examine the moderating effect of gender， so as to provide references for targeted interventions for NSSI behaviors in college students.Methods On March 1， 2024， a cluster sampling method was employed to select 518 college students from two universities in Heilongjiang Province. Assessments were conducted using Chinese version of the Childhood Trauma Questionnaire （CTQ）， the Difficulties in Emotion Regulation Scale （DERS）， the Patient Health Questionnaire Depression Scale-9 item （PHQ-9） and the Adolescent Self-Injury Questionnaire. Logistic regression analysis was used to examine the impact of cumulative family risk factors on NSSI behaviors among college students. Model 6 in Process 4.1 was applied to test the chain mediating roles of emotional regulation difficulties and depression in the relationship between cumulative family risk and NSSI behaviors， while model 83 was utilized to analyze the moderating effects of gender on the path "cumulative family risk → emotion regulation difficulties".Results A total of 475 （91.70%） college students completed valid questionnaires. Logistic regression analysis revealed that childhood abuse （OR=2.561， 95% CI： 1.566-2.561）， non-parental family structure （OR=2.108， 95% CI：1.102-4.029） and left-behind experience （OR=2.356， 95% CI： 1.021-5.439） were risk factors for NSSI behaviors among college students. Cumulative family risk positively predicted NSSI behaviors （β=0.345，95% CI：1.059-4.286， P<0.01）， and this relationship was mediated by a chain pathway involving emotional regulation difficulties （β=0.136，95% CI： 0.882-4.681， P<0.05） and depression （β=0.160， 95% CI： 0.316-1.073， P<0.01）. Gender moderated the relationship between cumulative family risk and emotional regulation difficulties （β=0.103， 95% CI： 1.567-8.316， P<0.01）， with cumulative family risk significantly predicting emotional regulation difficulties in female students （β=0.374， 95% CI： 0.099-0.084， P<0.01）.Conclusion Cumulative family risk can directly influence college students' NSSI behaviors， and may also indirectly affect NSSI behaviors through the mediating roles of emotional regulation difficulties and depression. The path "cumulative family risk → emotional regulation difficulties" in this mediating model is moderated by gender.［Funded by Heilongjiang Philosophy and Social Sciences Research Planning Project （number， 24SHB007）］