Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Dec 19, 2024; 14(12): 1936-1946
Published online Dec 19, 2024. doi: 10.5498/wjp.v14.i12.1936
Network analysis of adolescent non-suicidal self-injury subgroups identified through latent profile analysis
Wei Yang, Kun Lian, Yu-Qi Cheng, Xiu-Feng Xu, Xin-Cen Duan, Xu You
Wei Yang, Yu-Qi Cheng, Xiu-Feng Xu, Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
Kun Lian, Department of Neurosurgery, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
Xin-Cen Duan, Department of Psychiatry, Zhongshan Hospital Affiliated to Fudan University, Shanghai 201100, China
Xu You, Department of Psychiatry, Honghe Second People's Hospital, Honghe 651400, Yunnan Province, China
Co-first authors: Wei Yang and Kun Lian.
Co-corresponding authors: Yu-Qi Cheng and Xiu-Feng Xu.
Author contributions: Yang W and Xu XF conceptualized and designed the study, oversaw the entire project, and made the final decision to submit the manuscript; Yang W and Lian K have made critical and indispensable contributions to the completion of this project, thus qualifying as co-first authors; Duan XC contributed to the design of data collection tools, participated in data collection, and performed initial data analysis, which were critical in the early stages of the project; You X contributed to refining the data collection methodologies and ensured data integrity, enhancing the quality and reliability of the data; All authors have read and approved the final manuscript. Yang W was primarily responsible for drafting the manuscript, performing critical revisions, and ensuring the intellectual content and integrity of the work. Xu XF provided essential supervision, contributed significantly to data interpretation, and critically revised the manuscript for intellectual content. Cheng YQ and Xu XF served as co-corresponding authors. Lian K and Cheng YQ were involved in data curation. Yang W and Lian K played key roles in data verification and analysis, forming the backbone of the research findings. The collective efforts and collaboration of all authors were essential for the successful execution and publication of this research.
Supported by Yunnan Province High-Level Health Technical Talents, Leading Talents, No. L-2019011.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Kunming Medical University (Approval Number: KMMU2020MEC047) in September 2021.
Clinical trial registration statement: This study does not involve clinical trials and is not applicable.
Informed consent statement: All study participants or their legal guardians provided informed written consent before study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon reasonable request at xfxu2004@sina.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiu-Feng Xu, PhD, Chief Doctor, Director, Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Wuhua District, Kunming 650032, Yunnan Province, China. xfxu2004@sina.com
Received: May 13, 2024
Revised: October 6, 2024
Accepted: November 8, 2024
Published online: December 19, 2024
Processing time: 197 Days and 19.1 Hours
Abstract
BACKGROUND

Non-suicidal self-injury (NSSI) is common among adolescents and frequently co-occurs with depression. Understanding the distinct patterns of NSSI behaviors, along with their associated risk and protective factors, is crucial for developing effective interventions.

AIM

To classify NSSI behaviors and examine interactions between risk and resilience factors in Chinese adolescents.

METHODS

A cross-sectional study involving 3967 Chinese students (51.7% female, mean age 13.58 ± 2.24 years) who completed questionnaires on parenting styles, bullying, childhood maltreatment, depression, resilience, and NSSI. Latent profile analysis (LPA) was used to identify NSSI subtypes, and network analysis explored interactions between risk and resilience factors.

RESULTS

Three NSSI subtypes were identified: NSSI with depression (18.8%), NSSI without depression (12.3%), and neither (68.9%). Bullying was the central risk factor across subtypes, while emotional control and family support were key protective factors. Statistical analyses showed significant differences between groups (P < 0.001).

CONCLUSION

This study identified three NSSI subtypes among Chinese adolescents. Bullying emerged as a central risk factor, while emotional control and family support were key protective factors. Targeting these areas may help reduce NSSI behaviors in this population.

Keywords: Non-suicidal self-injury; Adolescent; Network analysis; Latent profile analysis; Resilience

Core Tip: Latent profile analysis (LPA): Utilized LPA based on self-injury and patient health questionnaire-9 depression assessments to uncover distinct non-suicidal self-injury (NSSI) profiles in adolescents, addressing the hypothesized heterogeneity between NSSI with and without depression. Network analysis insights: Identified differences in risk and resilience factors across NSSI subgroups. Bullying and depression connection: Demonstrated a strong link between bullying and depressive symptoms in NSSI subgroups. Intervention focal points: Pinpointed emotional control and family support as key areas for targeted interventions derived from LPA findings.