1
|
Yang W, Ning L, Miao Q, Xu F, Li K, Chen X, Lu H. The mediating roles of anxiety, loneliness, stress, and depression in the relationship between cyberbullying and non-suicidal self-injury: propensity score matching and causal mediation analysis. BMC Psychiatry 2025; 25:539. [PMID: 40420016 PMCID: PMC12105394 DOI: 10.1186/s12888-025-06943-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Accepted: 05/06/2025] [Indexed: 05/28/2025] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) not only causes direct physical harm but also severely impacts mental health, increasing the risks of psychological disorders, behavioral issues, and suicidal tendencies. With the widespread use of the internet and electronic communication tools on smartphones, such as social media and instant messaging applications, cyberbullying has become increasingly prevalent. However, research on the relationship between cyberbullying and NSSI remains relatively limited at present. METHODS This research was conducted in Nantong City, Jiangsu Province, from July to September 2024, utilizing a convenience sampling method with 1,751 participants. Propensity Score Matching (PSM) was employed to control for confounding factors, while causal mediation analysis was used to assess the mediating effects of anxiety, depression, stress, and loneliness between cyberbullying and NSSI. RESULTS In this study, 557 participants (31.8%) reported having experienced cyberbullying, Cyberbullying significantly increases NSSI odds through direct and indirect effects, mediated by anxiety (ACME = 0.08, ADE = 0.22, mediated proportion = 0.28), loneliness (ACME = 0.04, ADE = 0.26, mediated proportion = 0.14), stress (ACME = 0.05, ADE = 0.24, mediated proportion = 0.18), and depression (ACME = 0.06, ADE = 0.24, mediated proportion = 0.19). CONCLUSION This study explores the relationship between cyberbullying, mental health issues (depression, anxiety, stress, loneliness), and NSSI. Findings show cyberbullying directly and indirectly increases NSSI risk, with loneliness as a key mediator. Despite insights, the study has limitations, suggesting a need for more rigorous designs and comprehensive data.
Collapse
Affiliation(s)
- Weiyan Yang
- Science and Technology Department, Nantong First People's Hospital, Nantong city, Jiangsu Province, China
- The School of Public Health, Nantong University, Nantong city, Jiangsu Province, China
| | - Liyan Ning
- Science and Technology Department, Nantong First People's Hospital, Nantong city, Jiangsu Province, China
| | - Qingqing Miao
- The School of Public Health, Nantong University, Nantong city, Jiangsu Province, China
| | - Feng Xu
- Medical Examination Center, Nantong First People's Hospital, Nantong city, Jiangsu Province, China
| | - Kui Li
- Information Department, Nantong First People's Hospital, Nantong city, Jiangsu Province, China
| | - Xiangfan Chen
- Science and Technology Department, Nantong First People's Hospital, Nantong city, Jiangsu Province, China
| | - Hongjian Lu
- The School of Public Health, Nantong University, Nantong city, Jiangsu Province, China.
- President's Office, Nantong First People's Hospital, Nantong city, Jiangsu Province, China.
| |
Collapse
|
2
|
Xue J, Yan F, Hu T, He W. Family Functioning and NSSI Urges among Chinese Adolescents: A Three-wave Chain Multiple Mediation Model. J Youth Adolesc 2025; 54:1128-1139. [PMID: 39661229 DOI: 10.1007/s10964-024-02119-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 11/30/2024] [Indexed: 12/12/2024]
Abstract
Family functioning is used to evaluate the functioning of a family system, which exerts a huge influence on non-suicidal self-injury (NSSI). However, little is known about how family functioning relates to NSSI among adolescents, and existing research mainly depends on cross-sectional design, which cannot capture dynamic changes between variables. Additionally, NSSI urge has been established as a robust predictor of NSSI engagement and is clinically important. Guided by the integrated model of NSSI, the current study investigated two potential mediators (emotion regulation and self-esteem) of the relations between family functioning and NSSI urges to address these gaps. Participants were 1298 Chinese adolescents (50.5% male; Mage at Wave 2 = 15.08 years) from a three-wave longitudinal study with data spanning ten months. The results supported the chain multiple mediation model. Specifically, valid family functioning prevented NSSI urges through three indirect paths: (a) higher level of self-esteem; (b) more cognitive reappraisal to higher self-esteem; (c) less expressive suppression to higher self-esteem. The prediction of family functioning on cognitive reappraisal was weaker among girls, while the prediction of self-esteem on NSSI urges was stronger. These findings indicate that high family functioning is a powerful protective factor of NSSI urges, and NSSI interventions should aim to improve adolescents' family functioning, with attention to reinforcing emotion regulation and self-esteem, especially for girls.
Collapse
Affiliation(s)
- Jingxing Xue
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Feng Yan
- Jieshou No.1 Middle School, Jieshou, China
| | - Tianyi Hu
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China.
| | - Wen He
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China.
- Lab for Educational Big Data and Policymaking (Ministry of Education), Shanghai Normal University, Shanghai, China.
| |
Collapse
|
3
|
Li X, Liu J, Hu Y, Huang X, Li Y, Li Y, Shi Z, Yang R, Peng H, Ma S, Wan X, Peng W. The association of family functioning and suicide in children and adolescents: positive behavior recognition and non-suicidal self-injury as sequential mediators. Front Public Health 2025; 13:1505960. [PMID: 40034164 PMCID: PMC11873744 DOI: 10.3389/fpubh.2025.1505960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 02/04/2025] [Indexed: 03/05/2025] Open
Abstract
Background Suicide is a major behavioral issue among children and adolescents, and family functioning potentially influencing its occurrence. Furthermore, positive behavior recognition, as a key component of positive youth development, may act as a mediating factor in the relationship between family functioning and suicide. Non-suicidal self-injury (NSSI) often co-occurs with suicide and may also mediate the impact of family functioning on suicide. Therefore, the aim of this study is to examine the role of family functioning in child and adolescent suicide, with positive behavior recognition and NSSI serving as sequential mediating factors. Methods The participants in this study were recruited from the Chengdu Positive Child Development (CPCD) cohort study. The analysis was based on the second round of cross-sectional data from the CPCD cohort. They were required to complete questionnaires that included measures of family functioning, suicide, positive behavior recognition, and NSSI. SPSS 26.0 and Mplus 8.3 were used for descriptive statistical analysis, correlation analysis and mediation effect analysis. Results A total of 8,124 participants completed the questionnaires, with an average age of 11.00 ± 2.18 years. The sample comprised 4,195 male and 3,929 female participants. The findings indicate that 17.93% of children and adolescents reported suicide thoughts, 10.06% had formulated suicide plans, and 8.64% had attempted suicide. Poor family functioning shows a significant positive correlation with suicide (r = 0.322, p < 0.01). The multiple mediation effect of positive behavior recognition and NSSI in the association between family functioning and suicide was statistically significant (β = 0.034, 95% CI = 0.027, 0.042). Conclusion This study found that poor family functioning is a risk factor for suicide in children and adolescents, with positive behavior recognition and non-suicidal self-injury acting as sequential mediating factors.
Collapse
Affiliation(s)
- Xia Li
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Jiahe Liu
- School of Mathematics and Statistics, University of Melbourne, Parkville, VIC, Australia
| | - Yanling Hu
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Xi Huang
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Yingxin Li
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Yuan Li
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Zeyao Shi
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Ru Yang
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Hanmei Peng
- Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Sisi Ma
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xingli Wan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Wei Peng
- Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| |
Collapse
|
4
|
Zheng M, Gao Y, Li J, Liu X. Longitudinal Relationship between Aggressive Behavior and Non-Suicidal Self-Injury among Adolescent Boys and Girls: The Mediating Role of Peer Victimization. J Youth Adolesc 2025:10.1007/s10964-025-02149-0. [PMID: 39881123 DOI: 10.1007/s10964-025-02149-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Accepted: 01/21/2025] [Indexed: 01/31/2025]
Abstract
Although a large body of research has found associations between aggressive behavior and non-suicidal self-injury (NSSI), evidence for the directionality, underlying mechanisms, and potential gender differences in their associations remain unclear. To address the gaps, this study investigated the bidirectional relationship between aggressive behavior and NSSI, the mediating role of peer victimization (physical and relational victimization), and gender differences in these associations among a sample of Chinese adolescents. Using a longitudinal design, a total of 1394 Chinese adolescents (Mage = 13.39, SD = 0.59, 43.3% girls) completed surveys across three waves, with intervals of nine and six months, respectively. The results revealed that within the total sample, T1 aggressive behavior positively predicted T2 physical victimization, and T2 physical victimization positively predicted T3 NSSI. T1 NSSI positively predicted T2 relational victimization, and T2 relational victimization positively predicted T3 aggressive behavior. However, the indirect effect of T1 aggressive behavior on T3 NSSI mediated by T2 physical victimization was significant only for boys. The indirect effect of T1 NSSI on T3 aggressive behavior mediated by T2 relational victimization was significant only for girls. These findings highlighted the importance of considering the gender-specific process underlying the relationship between aggressive behavior and NSSI, thus guiding the development of gender-informed prevention and intervention strategies.
Collapse
Affiliation(s)
- Minjie Zheng
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jinwen Li
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.
| |
Collapse
|
5
|
Fasolato R, Raffagnato A, Miscioscia M, Gatta M. Non-suicidal self-injury in inpatient and outpatient adolescents: disentangling psychopathology and interactive family dynamics. Front Psychiatry 2025; 15:1483745. [PMID: 39866689 PMCID: PMC11759264 DOI: 10.3389/fpsyt.2024.1483745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 12/17/2024] [Indexed: 01/28/2025] Open
Abstract
Background Non-suicidal self-injury (NSSI) is defined as a transdiagnostic phenomenon that has well increased in the latest years, especially in the adolescent population. It has been associated with suicidality, alexithymia, emotion dysregulation, and psychosocial impairment, as well as family issues. The choice of level of care (i.e., hospitalization versus outpatient visit) depends on a number of factors that relate not only to suicidal risk but also to severity of individual's psychosocial functioning, the ability of family environment to support treatment choices and to contain child, as well as the need for ongoing monitoring of the young patient. A scarcity of studies has compared outpatients with inpatients, both of them engaging in NSSI. Methods the current study aimed to further expand knowledge regarding features that characterize young self-harmers who receive different levels of care, with particular attention on psychopathological, family, and NSSI-related characteristics, as well as suicidality. The current research included 56 inpatients and 56 outpatients with NSSI, paired for gender, age, and psychiatric diagnosis. Instruments investigating psychopathology, emotion dysregulation, alexithymia, psychosocial functioning, and interactive family dynamics were administered. Descriptive statistics, parametric and non-parametric inferential statistics were applied. Results study findings highlighted that inpatients engaging in NSSI reported lifetime suicidality, clinical level of externalizing and internalizing problems, more severe alexithymia, emotion dysregulation, and impaired psychosocial functioning compared to outpatients engaging in self-harming. Furthermore, when compared to outpatients' families, inpatients' families were more capable of adhering to rules and time of the family play situation (the Lausanne Trilogue Play procedure) and fixing interactive mistakes through activities. On the contrary, in the inpatient group, global performance, role implication, parental scaffolding, child's involvement and self regulation tend to decline, while parental conflicts tend to rise over the four part scenario of the family play. Conclusion these findings confirmed a more severe global picture of young inpatients engaging in self-harming, suggesting that NSSI may be the expression of this larger psychopathological picture. In addition, the study highlighted the need for a multi-informant and multimethod clinical assessment, which should include evaluation of family context and co-parenting system, especially for hospitalized young patients engaging in self-harm.
Collapse
Affiliation(s)
- Rachele Fasolato
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alessia Raffagnato
- Department of Women's and Children's Health, School of Medicine and Surgery, University of Padua, Padua, Italy
- Child Neuropsychiatry Unit, University Hospital of Padua, Padua, Italy
| | - Marina Miscioscia
- Department of Developmental and Social Psychology, University of Padua, Padova, Italy
| | - Michela Gatta
- Department of Women's and Children's Health, School of Medicine and Surgery, University of Padua, Padua, Italy
- Child Neuropsychiatry Unit, University Hospital of Padua, Padua, Italy
| |
Collapse
|
6
|
Liao X, Wang H, Ni X, Yu C. Family Economic Hardship and Non-Suicidal Self-Injury Among Chinese Adolescents: Relative Deprivation as a Mediator and Self-Esteem as a Moderator. Behav Sci (Basel) 2024; 14:1234. [PMID: 39767375 PMCID: PMC11673796 DOI: 10.3390/bs14121234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 12/18/2024] [Accepted: 12/20/2024] [Indexed: 01/11/2025] Open
Abstract
The literature provides empirical evidence that family economic hardship can increase the likelihood of adolescents engaging in non-suicidal self-injury (NSSI). However, the mechanisms underlying this relationship remain unclear. Guided by the risky families model, this study aimed to investigate whether relative deprivation mediates the link between family economic hardship and adolescent NSSI, and whether self-esteem moderates this indirect link. A combined 673 adolescents (45.9% female; Mage = 12.81 years) completed measures of family economic hardship, relative deprivation, self-esteem, and NSSI. The results verified that relative deprivation mediated the positive link between family economic hardship and NSSI. Additionally, self-esteem moderated the effect of family economic hardship on relative deprivation. Adolescents possessing high self-esteem reported lower relative deprivation compared to those possessing low self-esteem, regardless of their level of family economic hardship. Notably, the mitigating effect of high self-esteem diminished with high family economic hardship. These findings provide deeper insights into the mechanisms by which family economic hardship affect adolescent NSSI, and have practical implications for prevention and intervention strategies targeting this behavior.
Collapse
Affiliation(s)
- Xiaoyan Liao
- Department of Psychology, Research Center of Adolescent Psychology and Behavior, School of Education, Guangzhou University, Guangzhou 510006, China (X.N.)
| | - Huahua Wang
- School of Psychology, South China Normal University, Guangzhou 510631, China
| | - Xingcan Ni
- Department of Psychology, Research Center of Adolescent Psychology and Behavior, School of Education, Guangzhou University, Guangzhou 510006, China (X.N.)
| | - Chengfu Yu
- Department of Psychology, Research Center of Adolescent Psychology and Behavior, School of Education, Guangzhou University, Guangzhou 510006, China (X.N.)
| |
Collapse
|
7
|
Sun Y, Liu X, Li Y, Zhi Q, Xia Y. Effectiveness of individualized rTMS under sMRI guidance in reducing depressive symptoms and suicidal ideation in adolescents with depressive disorders: an open-label study. Front Psychiatry 2024; 15:1485878. [PMID: 39758440 PMCID: PMC11695401 DOI: 10.3389/fpsyt.2024.1485878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Accepted: 12/02/2024] [Indexed: 01/07/2025] Open
Abstract
Background Major Depressive Disorder (MDD) is occurring at a progressively younger age, and suicide is now the second leading cause of death among adolescents with MDD. Studies have shown that structural magnetic resonance imaging (sMRI) can improve the positioning accuracy and anti-depressant effects of repetitive transcranial magnetic stimulation (rTMS), thereby reducing suicidal ideation. Objective To compare the efficacy of sMRI-guided rTMS combined with pharmacotherapy, surface 5-cm rTMS positioning combined with pharmacotherapy, and pharmacotherapy alone on reducing depressive symptoms and suicidal ideation (SI) in MDD adolescents. Methods This was an open-label study of adjustable-dose pharmacotherapy combined with rTMS for the treatment of depressive symptoms and suicidal ideation in MDD adolescents. The three study groups were as follows: sMRI navigation for individualized rTMS coordinates targeting the dorsolateral prefrontal cortex (DLPFC) and in combination with pharmacotherapy for 10 rTMS sessions over two weeks; surface 5-cm positioning for DLPFC in combination with pharmacotherapy for 10 rTMS sessions over two weeks; pharmacotherapy. All patients received only one type of SSRIs anti-depressant. A total of 123 Chinese adolescents aged 13-18 with MDD were enrolled, and psychological parameters were evaluated in the first and second weeks of treatment. Results Following treatment, the clinical symptoms improved in all three groups. The sMRI navigation group exhibited significantly more improvement in depressive symptoms and suicidal ideation, without severe adverse reactions. Conclusion Ten sessions of rTMS treatment are feasible and effective in improving depressive symptoms and reducing SI in MDD adolescents. The combination of sMRI navigation rTMS and pharmacotherapy was found to yield the best outcomes. Clinical trial registration https://www.medicalresearch.org.cn/index, identifier MR-33-24-030536.
Collapse
Affiliation(s)
| | | | | | | | - Yong Xia
- Department of Psychiatry, Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| |
Collapse
|
8
|
Zhang J, Feng X, Wang W, Liu S, Zhang Q, Wu D, Liu Q. Predicting the Risk of Loneliness in Children and Adolescents: A Machine Learning Study. Behav Sci (Basel) 2024; 14:947. [PMID: 39457819 PMCID: PMC11504542 DOI: 10.3390/bs14100947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 09/28/2024] [Accepted: 10/11/2024] [Indexed: 10/28/2024] Open
Abstract
BACKGROUND Loneliness is increasingly emerging as a significant public health problem in children and adolescents. Predicting loneliness and finding its risk factors in children and adolescents is lacking and necessary, and would greatly help determine intervention actions. OBJECTIVE This study aimed to find appropriate machine learning techniques to predict loneliness and its associated risk factors among schoolchildren. METHODS The data were collected from an ongoing prospective puberty cohort that was established in Chongqing, Southwest China. This study used 822 subjects (46.84% boys, age range: 11-16) followed in 2019. Five models, (a) random forest, (b) extreme gradient boosting (XGBoost), (c) logistic regression, (d) neural network, and (e) support vector machine were applied to predict loneliness. A total of 39 indicators were collected and 28 predictors were finally included for prediction after data pre-processing, including demographic, parental relationship, mental health, pubertal development, behaviors, and environmental factors. Model performance was determined by accuracy and AUC. Additionally, random forest and XGBoost were applied to identify the important factors. The XGBoost algorithm with SHAP was also used to interpret the results of our ML model. RESULTS All machine learning performed with favorable accuracy. Compared to random forest (AUC: 0.87 (95%CI: 0.80, 0.93)), logistic regression (AUC: 0.80 (95%CI: 0.70, 0.89)), neural network (AUC: 0.80 (95%CI: 0.71, 0.89)), and support vector machine (AUC: 0.79 (95%CI: 0.79, 0.89)), XGBoost algorithm had the highest AUC values 0.87 (95%CI: 0.80, 0.93) in the test set, although the difference was not significant between models. Peer communication, index of general affect, peer alienation, and internet addiction were the top four significant factors of loneliness in children and adolescents. CONCLUSIONS The results of this study suggest that machine learning has considerable potential to predict loneliness in children. This may be valuable for the early identification and intervention of loneliness.
Collapse
Affiliation(s)
- Jie Zhang
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China (S.L.)
| | - Xinyi Feng
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China (S.L.)
| | - Wenhe Wang
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China (S.L.)
| | - Shudan Liu
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China (S.L.)
| | - Qin Zhang
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China (S.L.)
| | - Di Wu
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China (S.L.)
- College of Medical Informatics, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China
| | - Qin Liu
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China (S.L.)
| |
Collapse
|
9
|
Chen W, Gao Y, Xiao S. Predicting non-suicidal self-injury among Chinese adolescents: The application of ten algorithms of machine learning. Heliyon 2024; 10:e37723. [PMID: 39347408 PMCID: PMC11437845 DOI: 10.1016/j.heliyon.2024.e37723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 09/04/2024] [Accepted: 09/09/2024] [Indexed: 10/01/2024] Open
Abstract
Background and aims High non-suicidal self-injury (NSSI) prevalence among adolescents is a global health issue. However, current prediction models for adolescent NSSI rely on a limited set of algorithms, resulting in biased predictions. Therefore, the aim of this study is to develop multiple machine learning models to enhance prediction accuracy and mitigate biases among Chinese adolescents. Methods A total of 4487 junior and senior high school students in China were recruited. Multiple algorithms were included, such as logistic regression, decision tree, support vector machine, Naive Bayes, multi-layer perceptron, K-nearest neighbors, and ensemble learning algorithm like random forest, bagging, AdaBoost, and stacking to build predictive models. Data processing techniques, including standardization and the synthetic minority oversampling technique, were employed to optimize the predictive model. The model was trained on 70 % of the data, reserving 30 % for testing. Results The ten prediction models achieved a good performance, with area under the receiver operating characteristic curve (AUC) scores above 0.700 in the test set. The stacking and random forest models achieved AUC scores of 0.904 and 0.898, respectively. The prediction performance of the Naive Bayes model was relatively poor. The top five important variables were resilience, bully, suicidal ideation, internet addiction, and depression. Conclusions The ensemble machine learning algorithm showed promising results predicting NSSI among adolescents. Such algorithms should be recommended for future NSSI research to enhance predictive accuracy. Identification of important features in NSSI prediction can help develop screening protocols and lay a foundation for clinical diagnosis and intervention in adolescent populations.
Collapse
Affiliation(s)
- Wei Chen
- School of Psychology, Guizhou Normal University, Guiyang, China
- Inner Mongolia Student Bullying Prevention Research Center, Tongliao, China
| | - Yujing Gao
- School of Psychology, Guizhou Normal University, Guiyang, China
- Inner Mongolia Student Bullying Prevention Research Center, Tongliao, China
| | - Shiyin Xiao
- School of Psychology, Guizhou Normal University, Guiyang, China
- Inner Mongolia Student Bullying Prevention Research Center, Tongliao, China
| |
Collapse
|
10
|
Bao J, Wan J, Li H, Sun F. Psychological pain and sociodemographic factors classified suicide attempt and non-suicidal self-injury in adolescents. Acta Psychol (Amst) 2024; 246:104271. [PMID: 38631150 DOI: 10.1016/j.actpsy.2024.104271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/01/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
This study aimed to utilize machine learning to explore the psychological similarities and differences between suicide attempt (SA) and non-suicidal self-injury (NSSI), with a particular focus on the role of psychological pain. A total of 2385 middle school students were recruited using cluster sampling. The random forest algorithm was used with 25 predictors to develop classification models of SA and NSSI, respectively, and to estimate the importance scores of each predictor. Based on these scores and related theories, shared risk factors (control feature set) and distinct risk factors (distinction feature set) were selected and tested to distinguish between NSSI and SA. The machine learning algorithm exhibited fair to good performance in classifying SA history [Area Under Curves (AUCs): 0.65-0.87] and poor performance in classifying NSSI history (AUC: 0.61-0.68). The distinction feature set comprised pain avoidance, family togetherness, and deviant peer affiliation, while the control feature set included pain arousal, painful feelings, and crisis events. The distinction feature set slightly but stably outperformed the control feature set in classifying SA from NSSI. The three-dimensional psychological pain model, especially pain avoidance, might play a dominant role in understanding the similarities and differences between SA and NSSI.
Collapse
Affiliation(s)
- Jiamin Bao
- Department of Psychology, Renmin University of China, Beijing 100872, PR China
| | - Jiachen Wan
- Department of Psychology, Renmin University of China, Beijing 100872, PR China
| | - Huanhuan Li
- Department of Psychology, Renmin University of China, Beijing 100872, PR China.
| | - Fang Sun
- Department of Psychology, Renmin University of China, Beijing 100872, PR China
| |
Collapse
|