Childhood trauma, peer victimization, and non-suicidal self-injury among Chinese adolescents: a latent variable mediation analysis

Non-suicidal self-injury (NSSI) is defined as the deliberate direct destruction or alteration of body tissue without conscious suicidal intent [1]. In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), this diagnosis is denoted as a “condition for further study” [2]. Globally, the lifetime prevalence of at least one episode of NSSI in adolescence is 17–18% [3]. As early as 2016, the prevalence of adolescent NSSI was found to be 15.0% in the sample of Chinese adolescent communities [4]. Besides, a large-scale sampling survey in 2021 showed that the prevalence of NSSI was 28.5% among 18,900 Chinese junior and senior high school students [5]. Besides, a recent study reported that 33.7–51% of community youths engage in self-injurious behavior [6]. Moreover, a meta-analysis showed that individuals with mood disorders (anxiety, depression, bipolar, and related disorders) are at higher risk of NSSI compared to normal controls [7]. In an adolescent psychiatric sample, the prevalence of one-time-only NSSI behavior was as high as 60%, and the incidence of recurrent NSSI was approximately 50% [8]. A better understanding of the underlying mechanisms and risk factors for adolescent NSSI is crucial to inform prevention and intervention efforts.

Childhood trauma includes abuse and neglect by family members, especially primary caregivers [9], and has been identified as an important risk factor for the occurrence of NSSI [10] [11]. Neglect can be divided into two categories [12]: (1) physical neglect, where the basic requirements for the child’s survival are not met, such as nutrition and shelter [13].; (2) emotional neglect, where the basic psychological needs of the child are neglected or diluted. Abuse can be divided into the following categories: (1) physical abuse, which is intentional and violent physical injury; (2) emotional abuse, which refers to verbal and other mental attacks that harm a child’s health, including attacks on self-confidence, insults, and other behaviors that hinder a child’s normal growth; (3) sexual abuse, defined as an adult using violence, inducement, or other methods to engage in any form of sexual behavior with a child [14].

The interdependent parent-child relationship is a unique feature of Chinese society and family relationships play an irreplaceable role in the lives of Chinese children [15]. According to attachment theory, children function best when in a safe environment created by their parents. However, if a child does not feel safe, a child’s mind attempts to reduce the threats and create safety by fighting, fleeing, or freezing [16]. When adolescents are exposed to danger, decisions are made instantaneously by the brain; this process primarily involves conditioned responses formed during early childhood rather than complex processes performed by higher-order parts of the brain that are not fully formed until early adulthood (i.e., the prefrontal and anterior cingulate cortex, the parts of the brain responsible for language, associative, and regulatory functions) [17]. That is, the early environment also affects adolescents’ coping styles and behaviors when facing risks [18]. To sum up, childhood experiences also have a fundamental role in subsequent development that cannot be ignored [15]. Importantly, a recent meta-analysis found that adverse childhood experiences have significant independent effects on self-harm [19]. Further, several studies have indicated that childhood trauma can directly [20] or indirectly lead to the development of NSSI [21]. Although there is a time lag, the association between childhood trauma and NSSI in adolescence is significant.

Peer victimization is when an individual is repeatedly and chronically bullied or victimized by one or more peers [22], including: (1) physical victimization, involving physical attacks by peers; (2) verbal victimization, involving verbal abuse by peers; (3) social victimization, involving bullying by peers in a personal relationship; and (4) property victimization, involving stealing or destruction of property by peers [23]. Individuals who have experienced peer victimization have a greater risk of NSSI [24]. In the highly developed modern society, the psychological growth of adolescents is inseparable from the establishment of social relationships with family members, peers, and teachers; peer relationships account for a large proportion of the life of adolescents [25]. The influence of peer relationships on adolescents should not be ignored. According to interpersonal suicide theory (ITS), the desire to die may increase if a sense of burden and frustrated belonging is perceived in core interpersonal interactions, and this desire then leads to self-injury and suicidal behavior. Furthermore, integrative motivation-volition theory (IMV) suggests that negative life events, especially feelings that can be internalized as shame or frustration in interpersonal relationships, can lead to feelings of entrapment and subsequent suicidal thoughts and plans [26]. In a study of depressed adolescents, Vergara GA et al. reported that severe peer victimization and bullying led to NSSI [27]. Similarly, in another study, negative peer experiences were found to predict NSSI trajectories in depressed adolescents [28]. In summary, there is considerable evidence for a causal relationship between peer victimization and NSSI [29] [30].

In China, the saying goes ‘a single silk does not make a thread; a single tree does not make a forest’. Collectivism has always been a prominent characteristic of Chinese culture [31]. Even in modern society, there is a continuing cultural association between collectivism and some life domains [31]. In other words, Chinese people are more connected to the people around them, whether it is their family or friends. Several studies have reported that Chinese people have a higher level of dependency compared to people in

SDGs, Targets, and Indicators

SDGs

1. SDG 3: Good Health and Well-being
2. SDG 4: Quality Education
3. SDG 5: Gender Equality
4. SDG 10: Reduced Inequalities
5. SDG 16: Peace, Justice, and Strong Institutions

Targets and Indicators

The article addresses or is connected to the following SDGs:

• SDG 3: Good Health and Well-being – The article discusses non-suicidal self-injury (NSSI) as a mental health problem among adolescents.
• SDG 4: Quality Education – The article mentions the importance of understanding the impact of childhood trauma and peer victimization on adolescent mental health to inform prevention and intervention efforts.
• SDG 5: Gender Equality – The article highlights the higher prevalence of NSSI among females compared to males.
• SDG 10: Reduced Inequalities – The article discusses the impact of childhood trauma and peer victimization on adolescent mental health, which can contribute to inequalities in well-being.
• SDG 16: Peace, Justice, and Strong Institutions – The article explores the relationship between childhood trauma, peer victimization, and NSSI, which are forms of abuse and violence.

The specific targets and indicators identified based on the article’s content are:

• Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
• Indicator 3.4.2: Suicide mortality rate
• Target 4.7: By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including among others through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship and appreciation of cultural diversity and of culture’s contribution to sustainable development
• Indicator 4.7.1: Extent to which (i) global citizenship education and (ii) education for sustainable development are mainstreamed in (a) national education policies; (b) curricula; (c) teacher education; and (d) student assessment
• Target 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation
• Indicator 5.2.1: Proportion of ever-partnered women and girls aged 15 years and older subjected to physical, sexual or psychological violence by a current or former intimate partner in the previous 12 months, by form of violence and by age group
• Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status
• Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex and persons with disabilities
• Target 16.2: End abuse, exploitation, trafficking and all forms of violence against and torture of children
• Indicator 16.2.2: Number of victims of human trafficking per 100,000 population, by sex, age group and form of exploitation

The article provides detailed explanations and specific information to support the analysis of the SDGs, targets, and indicators.

Table: SDGs, Targets, and Indicators

Behold! This splendid article springs forth from the wellspring of knowledge, shaped by a wondrous proprietary AI technology that delved into a vast ocean of data, illuminating the path towards the Sustainable Development Goals. Remember that all rights are reserved by SDG Investors LLC, empowering us to champion progress together.

Source: springermedizin.de

Join us, as fellow seekers of change, on a transformative journey at https://sdgtalks.ai/welcome, where you can become a member and actively contribute to shaping a brighter future.