Peer-reviewed article
The effect of parental marital status on non-suicidal self-injurious behavior among middle school students in rural western China: a multicenter cross-sectional study based on propensity score matching method.
Ren X, Pan L, Song Y, He P, Wu D et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined the relationship between parental marital status and non-suicidal self-injury (NSSI) among middle school students in rural western China. The research involved over 8,600 students, comparing those from divorced and non-divorced families. After controlling for confounding factors using statistical matching, adolescents from divorced families showed significantly higher odds of engaging in self-injury, though emotional distress did not fully explain this relationship.
Key points
- NSSI prevalence was 4.1% in non-divorced families and 1.6% in divorced families before matching
- After propensity score matching, parental divorce was associated with significantly increased odds of NSSI
- Depression and anxiety were independent risk factors for NSSI
- Emotional distress did not mediate the relationship between parental divorce and NSSI
- Girls and older adolescents showed higher rates of NSSI
Limitations
The cross-sectional design cannot establish causation or determine directionality of effects. The study is limited to rural western China and may not be generalizable to urban areas or other regions.
Abstract
Introduction Parental marital status is a pivotal determinant of adolescent maladaptive behaviors. However, the specific correlation between parental marital status and Non-Suicidal Self-Injury (NSSI) among adolescents in western China has not been thoroughly investigated. Methods A cross-sectional study was conducted involving 7,274 students from non-divorced families and 1,332 from divorced families. Participants were assessed using the Ottawa Self-Injury Inventory (OSI) and the Depression, Anxiety, and Stress Scale-21 Items (DASS-21). Propensity score matching (PSM) was applied to control for confounders, and logistic regression was used to analyze associations. Results The prevalence of non-suicidal self-injury (NSSI) was higher in adolescents from non-divorced families (4.1%) than in those from divorced families (1.6%). However, propensity score matching analysis revealed that parental divorce was associated with a significantly increased odds of NSSI after controlling for confounders. Furthermore, depression and anxiety were identified as independent risk factors for NSSI. Mediation analysis indicated that the emotional distress (depression, anxiety, and stress) did not significantly mediate the relationship between parental divorce and NSSI. Additional significant predictors of NSSI included girls and age. Discussion Adolescents from divorced families in western China show a higher incidence of NSSI, though this relationship is not mediated by emotional distress. These findings highlight the need for families and society to enhance attention to the psychological well-being of this vulnerable adolescent population.