A prediction model for non-suicidal self-injury behavior risk among children aged 10 to 13 years
GONG Liangliang1,2, RONG Zhidong1
1. Cixi Center for Disease Control and Prevention, Cixi, Zhejiang 315300, China; 2. School of Public Health, Zhejiang University, Hangzhou, Zhejiang 311121, China
Abstract：Objective To establish a prediction model for non-suicidal self-injury (NSSI) behavior risk among children aged 10 to 13 years, so as to provide the basis for early prevention and intervention of NSSI behavior in children. Method Students aged 10 to 13 years from four primary schools in Cixi City, Zhejiang Province from 2023 to 2024 were selected using a stratified cluster sampling method. Basic information, parents' marital status, family functioning, peer relationships, and academic satisfaction were collected through a questionnaire survey. The NSSI behavior in the past year was investigated by the Adolescent NSSI Behavior Rating Scale. The influencing factors for NSSI behavior were screened using a multivariable logistic regression model. A nomogram was established and verified with receiver operating characteristic (ROC) curve. Hosmer-Lemeshow goodness of fit test was used to evaluate the fitting effect and Bootstrap method was used for internal verification. Results A total of 986 students were surveyed, including 516 boys (52.33%) and 470 girls (47.67%). In the past year, 173 students (17.55%) engaged in NSSI behavior. The multivariable logistic regression model identified four influencing factors of NSSI behavior, and the prediction model was established as follows: ln[p/(1-p)]=-2.930+0.747×recent unpleasant events in the past week+0.441×having new media accounts+0.972×self-rated poor health status+0.557×self-rated general health status+0.745×family functioning. The area under the ROC curve was 0.791 (95%CI: 0.754-0.827), with a sensitivity of 0.792 and a specificity of 0.636. Conclusions The constructed nomogram model demonstrates a certain degree of discrimination, with good calibration and stability. It can be used to roughly predict the risk of NSSI behavior occurrence among children aged 10 to 13 years.
龚亮亮, 戎志东. 10~13岁儿童非自杀性自伤行为风险预测模型研究[J]. 预防医学, 2025, 37(6): 546-550.
GONG Liangliang, RONG Zhidong. A prediction model for non-suicidal self-injury behavior risk among children aged 10 to 13 years. Preventive Medicine, 2025, 37(6): 546-550.
[1] 潘江艳,杨盼,陆新园.青少年抑郁症住院患者非自杀性自伤行为现状及危险因素探究[J].心理月刊,2024,19(8):57-59. PAN J Y,YANG P,LU X Y.Exploration of the current status and risk factors of non suicidal self injury behavior among hospitalized adolescents with depression[J].Psycho Mag,2024,19(8):57-59.(in Chinese) [2] JOINER T E.Why people die by suicide[M].Cambridge:Harvard University Press,2007. [3] 孙灯勇,魏小涵.不可忽视的青少年自毁行为:非自杀性自伤[J].晋中学院学报,2022,39(5):90-95. SUN D Y,WEI X H.Self destructive behavior of adolescents that cannot be ignored:non-suicidal self-injury[J].Jinzhong Univ J,2022,39(5):90-95.(in Chinese) [4] LIM K S,WONG C H,MCINTYRE R S,et al.Global lifetime and 12-month prevalence of suicidal behavior,deliberate self-harm and non-suicidal self-injury in children and adolescents between 1989 and 2018:a meta-analysis[J].Int J Environ Res Public Health,2019,16(22):4581-4606. [5] 勾小星. 人本中心模式介入青春期青少年厌学情绪实务研究[D].武汉:华中科技大学,2019. GOU X X.Practical study on the intervention of humanistic center model in adolescent aversion to learning[D].Wuhan:Huazhong University of Science and Technology,2019.(in Chinese) [6] 李凌宇,史佳伟,魏丹,等.青少年非自杀性自伤成因及动机质性研究的Meta整合[J].精神医学杂志,2023,36(5):493-500. LI L Y,SHI J W,WEI D,et al.Qualitative studies on causes and motivations of non-suicidal self-injury in adolescents:a meta-synthesis[J].J Psychiatry,2023,36(5):493-500.(in Chinese) [7] 李荣风,徐夫真,纪林芹,等.家庭功能评定量表的初步修订[J].中国健康心理学杂志,2013,21(7):996-1000. LI R F,XU F Z,JI L Q,et al.Revision of Family Assessment Device[J].China J Health Psychol,2013,21(7):996-1000.(in Chinese) [8] 万宇辉,刘婉,郝加虎,等.青少年非自杀性自伤行为评定问卷的编制及其信效度评价[J].中国学校卫生,2018,39(2):170-173. WAN Y H,LIU W,HAO J H,et al.Development and evaluation on reliability and validity of Adolescent Non-suicidal Self-injury Assessment Questionnaire[J].Chin J Sch Health,2018,39(2):170-173.(in Chinese) [9] CAROLIN D,CHRISTINE M B,SÖREN K,et al.Epidemiology of suicidal ideation,suicide attempts,and direct self-injurious behavior in adolescents with a migration background:a representative study[J].BMC Pediatrics,2019,19:45-59. [10] 万孝先,张伶俐,胡小平,等.家庭教养方式与儿童非自杀性自伤行为关联分析[J].中国社会医学杂志,2023,40(6):705-709. WAN X X,ZHANG L L,HU X P,et al.Analysis of relationship between parental rearing styles and non-suicidal self-injury behavior among school-age children[J].Chin J Soc Med,2023,40(6):705-709.(in Chinese) [11] 王敬群,陈丽霞,黄青.非自杀性自伤(NSSI)行为研究(综述)[J].江西开放大学学报,2023,25(3):79-85. WANG J Q,CHEN L X,HUANG Q.Research on non-suicidal self-injury(NSSI)behavior(review)[J].J Jiangxi Open Univ,2023,25(3):79-85.(in Chinese) [12] 段文静,谢煜相,羊姝,等.中学生非自杀性自伤风险的潜在剖面分析[J].预防医学,2025,37(2):118-122. DUAN W J,XIE Y X,YANG S,et al.Latent profile analysis of non-suicidal self-injury risk among middle school students[J].China Prev Med J,2025,37(2):118-122.(in Chinese) [13] WANG L,LIU X,LIU Z Z,et al.Digital media use and subsequent self-harm during a 1-year follow-up of Chinese adolescents[J].J Affect Disord,2020,277:279-286. [14] 伍晓艳,陶芳标.数字媒体使用对儿童青少年心理健康影响的双刃剑效应[J].中国学校卫生,2020,41(11):1601-1605. WU X Y,TAO F B.Further thinking about the double-edged sword effect of digital media use on mental health among children and adolescents[J].Chin Sch Health,2020,41(11):1601-1605.(in Chinese) [15] ÇIMENİ D,COŞKUN A,ETILER N.Non-suicidal self-injury behaviors,features and relationship with adolescents,daily life activities and mental status[J].Turk J Pediatr,2017,59(2):113-121. [16] 张珊珊,张野.农村留守中学生自尊与非自杀性自伤行为的关系[J].中国健康教育,2019,35(12):1099-1103. ZHANG S S,ZHANG Y.The relationship between self-esteem and non-suicidal self-injurious behavior among left-behind middle school students:mediating effects of bullying and shame[J].Chin J Health Educ,2019,35(12):1099-1103.(in Chinese) [17] CARR E G.The motivation of self-injurious behavior:a review of some hypotheses[J].Psychol Bull,1977,84(4):800-816. [18] 王俊玲,郭菲,陈祉妍.孤独感、抑郁症状在父母冲突与青少年非自杀性自伤间的中介效应研究[J].预防医学,2023,35(12):1029-1032. WANG J L,GUO F,CHEN Z Y.Mediating effects of adolescent loneliness and depressive symptoms on inter parental conflict and adolescent non-suicidal self-injury[J].China Prev Med J,2023,35(12):1029-1032.(in Chinese)
