Multidimensional stress and self-harm in Chinese preadolescents: A cross-sectional study

Background: Limited research has been conducted on self-harm among preadolescents in China. This study investigated the influence of multidimensional stress on high levels of self-harm behavior in preadolescents.

Method: This large-scale cross-sectional study of 7-14-year-old primary school students in grades 3-6 was conducted in Southwest China between September and December 2020. Data on sociodemographic characteristics and multidimensional stressors were collected and analyzed.

Results: The self-harm prevalence among the 48,117 preadolescents was 13.6 % (n = 6561), with respective prevalence rates of 13.2 % in males and 14.1 % in females. Chi-square and binary logistic regression analyses were employed. The most important factors for self-harm were ranked as follows: high academic pressure (OR = 2.00, 95 % CI 1.90-2.09), poor relationship with parents (OR = 1.89, 95 % CI 1.78-2.00), frequently being bullied (OR = 1.53, 95 % CI 1.47-1.60), early-onset menstruation (OR = 1.33, 95 % CI 1.22-1.46), frequent smartphone use (OR = 1.31, 95 % CI 1.26-1.37), poor classmate relationships (OR = 1.31, 95 % CI 1.24-1.38), poor relationship between parents (OR = 1.11, 95 % CI 1.08-1.14), poor family financial situation (OR = 1.11, 95 % CI 1.05-1.17), and being bullied within the past 1 month (OR = 1.05, 95 % CI 1.02-1.07).

Limitations: The limitations of this study include its cross-sectional design, the use of a non-structured questionnaire, the subjectivity of some items, the reliance on a single question about self-harm, and the possibility that participants may have concealed the true nature of their behaviors.

Conclusion: Preadolescents in China exhibited high rates of self-harm behaviors. It is recommended that schools and families pay more attention to the mental health of preadolescent students, especially with regard to self-harm, and develop targeted interventions to address this issue.