Self-injury and suicidal ideation among Chinese adolescents involved in different subtypes of aggression: The role of gender.

BACKGROUND: Although aggression associated self-injury and suicidal ideation, but the specific impact of different subtypes of aggression is unclear. Therefore, the current study aims to quantify the associations between five subtypes of aggression, self-injury, and suicidal ideation in Chinese adolescents. METHOD: A total of 18,532 students were recruited in grades 7 to 12 using a stratified cluster sampling across five representative provinces in China. The Functional Assessment of Self-Mutilation (CH-FASM) and Buss and Warren's Aggression Questionnaire (BWAQ) assess self-injury and aggression, respectively. RESULTS: During the last year, the proportion of self-injury, suicidal ideation, and self-injury plus suicidal ideation (SSI) were 13.4 %, 10.0 %, 12.4 %, respectively. Multivariate logistic regression indicated that hostility was associated with self-injury-only (OR = 1.033, 95 % CI = 1.021-1.044), suicidal ideation-only (OR = 1.075, 95 % CI = 1.061-1.088), and SSI (OR = 1.100, 95 % CI = 1.087-1.114) (all P < 0.001) across five subtypes of aggression. In gender stratification, physical aggression was risk factor for self-injury-only, suicidal ideation-only, and SSI (OR = 1.028, 95 % CI = 1.018-1.037, P < 0.001) in females. While anger was association with self-injury-only and suicidal ideation-only in males (P < 0.05). LIMITATIONS: This study was a cross-sectional design and self-reported questionnaire. CONCLUSION: Hostility is a strong predictor of self-injury and suicidal ideation across five subtypes of aggression. There are gender differences in relationships. Prevention programs for adolescents' self-injury and suicidal ideation should consider different subtypes of aggression and gender differences.

Mobile phone addiction and suicide behaviors among Chinese adolescents: The mediation of poor sleep quality.

Background and aims: Mobile phone addiction (MPA) is emerging among adolescents, especially during the COVID-19 pandemic. Nevertheless, there is a dearth of knowledge regarding the correlation between MPA and suicide behaviors and its mechanism. The objective of the current study is exploring the direct effect of MPA on suicide behaviors and the indirect effect through poor sleep quality. Methods: A total of 18,900 Chinese adolescents aged 12 to 18 were recruited via a multi-stage cluster sampling method. Results: The prevalence of MPA and poor sleep quality was 26.2 and 23.1%, respectively. During the past year, 24.4% participants were involved in suicide behaviors. Specifically, suicide ideators, suicide planners, and suicide attempters were 10.7, 8.4, and 5.3%, respectively. Particularly, rural females had the highest prevalence of suicide behaviors, MPA, and poor sleep quality. Logistic regression analysis showed that MPA was significantly associated with suicide ideators (OR = 1.22, 95% CI: 1.09-1.37, p < 0.001) and planners (OR = 1.18, 95% CI: 1.04-1.34, p < 0.05), but not for suicide attempters (p > 0.05). Structural equation modelling demonstrated that MPA had direct effect on suicide behaviors (ß = 0.145, 95% CI = 0.127-0.160), and poor sleep quality partially mediated the relationship (the mediating ratio was 46.7%). The mediating ratio of poor sleep quality was the highest in urban males. Conclusions: MPA has both direct and indirect effects on suicide behaviors. For suicide prevention, limited mobile phone use and improvement sleep quality may be practical for adolescents. Additionally, more efforts of intervention could give priority to rural girls.

Specific and cumulative effects of childhood maltreatment on nonsuicidal self-injury in Chinese adolescents: The moderating effect of sleep disturbance.

BACKGROUND: Numerous studies have examined the relationship between childhood maltreatment (CM) and nonsuicidal self-injury (NSSI). However, few studies have explored both the specific and cumulative effects of CM on NSSI. Additionally, the impact of sleep disturbance on the association between CM and NSSI remains unclear. OBJECTIVES: To comprehensively explore the effects of CM on NSSI, and to determine whether these effects are moderated by sleep disturbance. PARTICIPANTS AND SETTING: A retrospective study was conducted in April 2021 among a representative sample of 21,340 students aged 11-20 years in China. METHODS: All participants completed questionnaires assessing CM, sleep disturbance, and NSSI. Adjusted multivariate logistic regression models were utilized to evaluate the associations between CM and NSSI, as well as the impact of sleep disturbance. RESULTS: The findings revealed that 13.0 % of adolescents reported occasional NSSI, while 25.2 % reported repetitive NSSI. Except for sexual abuse, all subtypes of CM were significantly associated with increased odds of both occasional and repetitive NSSI. A significant dose-response relationship was observed between cumulative CM and repetitive NSSI. Stratification analyses by sleep disturbance indicated that adolescents reporting sleep disturbance had a higher risk of developing repetitive NSSI, irrespective of the type of CM experienced. Furthermore, a dose-response relationship was identified between cumulative CM and repetitive NSSI among adolescents reporting sleep disturbance. CONCLUSION: This study demonstrated that CM increases the risk of NSSI among Chinese adolescents, and sleep disturbance plays a moderating role. Interventions targeting sleep disturbance may hold significance in reducing NSSI.

Specific effects of five subtypes of childhood maltreatment on suicide behaviours in Chinese adolescents: the moderating effect of sex and residence.

AIMS: Although childhood maltreatment has been widely supported to be a robust predictor of suicide behaviours, the effects of different childhood maltreatment subtypes remain controversial and inconclusive. Moreover, whether the effects differ by sex in urban and rural adolescents is still unknown. This study aimed to quantify the associations between five subtypes of childhood maltreatment and different suicide behaviour involvement. METHODS: A multistage cluster sampling method was adopted from April to December 2021 for adolescents aged 12 to 18 across five representative provinces of China. The Childhood Trauma Questionnaire-Short Form was used to measure childhood maltreatment subtypes. Suicide behaviour involvement was classified as none group, suicide ideator, suicide planner and suicide attempter. Confounding variables include demographic characteristics, smoking, drinking alcohol, depression and anxiety. RESULTS: Among a total of 18,980 adolescents, 2021 (10.6%) were suicide ideator, 1595 (8.4%) were suicide planner and 1014 (5.3%) were suicide attempter. Rural females had the highest proportion of suicide ideator (13.8%) and suicide planner (11.5%). Multinomial logistic regression analysis indicated that five childhood maltreatment subtypes were independently associated with suicide behaviours, except for associations between sexual abuse and suicide ideator as well as suicide planner (p > 0.05). Moreover, these associations differ by sex and residence. After adjusted for interactions of different subtypes, structural equation model indicated that the direct effects of childhood maltreatment subtypes on suicide behaviours from high to low were emotional abuse (ß = 0.363, p < 0.001), physical abuse (ß = 0.100, p < 0.001) and sexual abuse (ß = 0.033, p = 0.003), while the effects of physical neglect and emotional neglect were not significant (p > 0.05). CONCLUSIONS: Five subtypes of childhood maltreatment have specific and non-equivalence associations with suicide behaviours. Emotional abuse may have the strongest effect, and sexual abuse have an acute effect on suicide behaviours. Suicide prevention programs for Chinese adolescents could focus on those who experienced emotional, physical and sexual abuse. Furthermore, strategies should be tailored by sex and residence, and rural females deserve more attention.

Association between problematic smartphone use, chronotype and nonsuicidal self-injury among adolescents: A large-scale study in China.

BACKGROUND: Nonsuicidal self-injury (NSSI) is a serious public health and clinical problem, particularly for adolescents, and may link to problematic smartphone use (PSU) and chronotype. This study examines the independent and interaction effects of PSU and chronotype on NSSI among adolescents and identified gender differences in these associations. METHODS: A total of 21,357 students aged 11-19 were recruited using stratified cluster sampling across five representative provinces in China and completed standard questionnaires to record details of PSU, chronotype, and NSSI. RESULTS: A total of 38.1 % of students reported having engaged in NSSI and 17.7 % had PSU. PSU and chronotype were significantly associated with NSSI among adolescents, and this relationship was stronger in females. Interaction analysis indicated that E-type and PSU were interactively associated with increased risks of NSSI. CONCLUSION: The findings suggest that E-type and PSU can increase the risk of NSSI both independently and interactively. Therefore, they should be considered in intervention programs for NSSI, especially for females.

Psychometric properties and normative data of the childhood trauma questionnaire-short form in Chinese adolescents.

Background: The Childhood Trauma Questionnaire-Short Form (CTQ-SF) is a widely utilized instrument of childhood maltreatment (CM). However, psychometric properties and normative data of the CTQ-SF for Chinese adolescents are still unknown. Objective: To examine psychometric properties and normative data of Chinese version CTQ-SF in a nationally representative sample of Chinese adolescents, including internal consistency reliability, test-retest reliability, structural validity, and convergent validity. Method: A total of 20,951 adolescents aged 12 to 18 years were recruited from five provinces across China. Item analysis was used for 25 clinical items of the CTQ-SF. Confirmatory factor analysis was performed to examine fit indices of the factor structure. The Adverse Childhood Experiences Scale (ACEs) was used to evaluate convergent validity. The percentile ranks for scores of the CTQ-SF and each subscales were presented. Results: According to the results of three methods in Item analysis, Item 4 should be dropped. The remaining 24 clinical items achieved satisfactory fits in an alternative four-factor model. The alternative CTQ-SF showed acceptable internal consistency and the Cronbach's α of the four subscales was 0.824 (Neglect), 0.755 (Sexual Abuse), 0.713 (Physical Abuse), and 0.666 (Emotional Abuse), respectively. Besides, test-retest reliability and convergent validity of the alternative CTQ-SF were also acceptable. Conclusion: The alternative four-factor model CTQ-SF exhibits good reliability and validity among Chinese adolescents. Additionally, the normative information of the CTQ-SF could provide practical support for determining severity of different subtypes of CM.

Association between sexual orientation and high risk sexual behaviors among college students in Hubei Province / 中国学校卫生

Objective@#To examine the association between sexual orientation and high risk sexual behaviors and its sex differences among college students, so as to provide a theoretical basis for intervention and controlling of high risk sexual behaviors of the college students.@*Methods@#From November 2020 to May 2021, 1 920 college students among four universities in Hubei Province were recruited by multi stage stratified random cluster sampling, and their sexual orientation and the frequency of high risk sexual behaviors were investigated by a self designed questionnaire. And then analyzed the association between sexual orientation and high risk sexual behaviors and its sex differences by using Chi square test and Logistic regression analysis method.@*Results@#The prevalence of sexual behaviors was 18.2%, the prevalence of high risk sexual behaviors was 7.2%, and the prevalence of high risk sexual behaviors was higher among non heterosexuals(13.5%) than among heterosexuals (6.7%),the prevalence of high risk sexual behaviors was higher among males (9.2%) than among females(5.3%)，and the differences were statistically significant( χ 2=9.40, 10.77, P <0.01). Logistic regression analysis showed that the association between sexual orientation and high risk sexual behaviors was not statistically significant( OR=1.52, 95%CI=0.83-2.80, P >0.05). However, stratified analysis by sex revealed that among male students, the risk of high risk sexual behaviors was 3.57 times higher among non heterosexuals than among heterosexuals( OR= 3.57 , 95%CI=1.52-8.41, P <0.01), while among female students, the association between sexual orientation and high risk sexual behaviors was not statistically significant( OR=0.48, 95%CI=0.15-1.57, P >0.05).@*Conclusion@#There are sex differences in the relationship between sexual orientation and high risk sexual behaviors among college students. Male non-heterosexuals are at higher risk for high risk sexual behaviors than male heterosexuals. Therefore, prevention and interventions for high risk sexual behaviors among college students should focus on gay and bisexual men so as to reduce the occurance rate of their high risk sexual behaviors.

Relationship between adolescent parent attachment and attempted suicide among middle school students / 中国学校卫生

Objective@#To understand the current situation of suicide attempts in middle school students and to explore its relation with adolescent parent attachment, to provide a basis for the prevention and control of middle school students suicidal behavior.@*Methods@#A total of 4 419 students from grades 7 to 12 in Ezhou City and Xiaogan City, Hubei Province were selected by stratified cluster random sampling. The Inventory of Parent and Peer Attachment, Rosenberg Self Esteem Scale, Kessler Psychological Distress Scale were used to conduct a questionnaire Survey, and evaluated the suicide attempts of middle school students.@*Results@#The detection rate of attempted suicide among middle school students was 6.8%. The detection rate of attempted suicide varies among different grades, family types, parental relation, parenting style, family income, self esteem level, and psychological distress( χ 2/ t =3.88, 10.12, 18.00, 52.54, 13.90 , 2.37, 8.99, P <0.05). The scores of paternal attachment and maternal attachment ( 14.64 ±13.45, 14.77±12.26) in the group with attempted suicide were lower than those without attempted suicide(22.05±16.08, 23.79±14.93)( t =-9.07, -12.11, P <0.05). Logistic regression analysis showed that both paternal attachment and maternal attachment were associated with lower rate of suicide attempts among middle school students(paternal attachment, OR=0.99, 95%CI = 0.98 -0.99; maternal attachment OR=0.97, 95%CI =0.96-0.98), with paternal attachment for girls only( OR=0.98, 95%CI= 0.97 -0.99)(P <0.05).@*Conclusion@#Adolescent parent attachment may be a protective factor for middle school students suicide attempts. Sex specific effects are observed in adolescent father attachment in girls. Parents should pay attention to cultivating a good attachment relationship with their children and promote the healthy growth of middle school students.

Association between childhood physical abuse and suicidal behaviors among Chinese adolescents: The mediation of aggression.

BACKGROUND: Although previous studies have examined many predictors of suicidal behaviors. However, little is known for childhood physical abuse (CPA) and aggression, which are prevalent among adolescents. This study aimed to explore association between CPA and suicidal behaviors, and the potential mediating role of aggression. METHOD: A total of 16,111 students graded 7 to 12 were recruited using a stratified cluster sampling across five representative provinces in China. Conflict Tactics Scale-Parents to Child (CTS-PC) and Buss and Warren's Aggression Questionnaire (BWAQ) were used to measure CPA and aggression, respectively. RESULTS: During the last year, 16.0 % of adolescents reported suicidal behaviors. Specifically, 7.9 % were suicide ideators, 4.6 % were planners, and 3.5 % were attempters. The prevalence of CPA in mild, moderate, and severe was 15.7 %, 26.9 %, and 4.4 %, respectively. Multinomial logistic regression indicated that moderate and severe CPA and overall aggression were associated with suicide ideators, planners, and attempters. In five sub-types of aggression, only hostility was significantly associated with all three suicidal behaviors. Structural equation modelling showed that aggression partially mediate the relationship between CPA and suicidal behaviors. The mediation proportion of overall aggression, physical aggression, verbal aggression, anger, hostility, and indirect aggression were 27.2 %, 22.4 %, 5.2 %, 14.2 %, 23.5 %, and 12.1 %, respectively. LIMITATIONS: Cross-sectional design, self-reported questionnaire, and no other forms of childhood maltreatment. CONCLUSIONS: CPA is a critical risk factor of suicidal behaviors among Chinese adolescents and aggression is a mediator between CPA and suicidal behaviors. Targeted suicide prevention should focus on those adolescents who report CPA and aggression, especially for hostility.

Co-occurrence of sibling and peer bullying victimization and depression and anxiety among Chinese adolescents: The role of sexual orientation.

BACKGROUND: Bullying victimization is a robust predictor of mental distress among lesbian/gay, bisexual, and questioning (LGBQ) adolescents. However, few research accounted bullying victimization within the context of both sibling and peer relationships. OBJECTIVE: To examine the effect of sibling and peer bullying victimization on depression and anxiety between heterosexual adolescents and LGBQ adolescents. METHOD: This was a cross-sectional study with a random sample of 3062 Chinese senior high school students (56.0% female) aged 14 to 18. Related information was collected through a self-reported questionnaire. The associations were examined via a set of logistic regression analysis. RESULTS: Of the participants, 12.5% were victims of sibling bullying only, 10.1% reported peer victimization only, and 4.7% were involved in both sibling and peer victimization. Compared to heterosexuals, LGBQ adolescents had increased risks of sibling victimization only, peer victimization only, and both sibling and peer victimization. The prevalence of major depression and generalized anxiety disorder were 24.9% and 18.7% respectively. Bullying victimization and sexual orientation were independently associated with depression and anxiety. Furthermore, the stratified analysis indicated that sibling victimization only was significantly associated with depression and anxiety for heterosexual adolescents, while the associations were not significant for LGBQ adolescents. CONCLUSIONS: Sexual orientation and bullying victimization are predictive factors of depression and anxiety. In particular, bullying victimization shows the different effects on depression and anxiety between heterosexual and LGBQ adolescents. Anti-bullying intervention could take distinct strategies based on different sexual orientation to reduce risks of adolescents' mental health problems.

Sex differences in association between Internet addiction and aggression among adolescents aged 12 to 18 in mainland of China.

BACKGROUND: Previous studies have reported that Internet addiction (IA) is an important predictor of aggression. However, little is known whether aggression is a risk factor of IA. This study aims to explore whether IA can predict total and sub-types of aggression, whether aggression also can predict IA, and the potential sex difference. METHOD: A total of 15,977 adolescents aged 12 to 18 were recruited though a stratified cluster sampling across five representative provinces in mainland of China. Young's Internet Addiction Test (IAT) and Buss and Warren's Aggression Questionnaire (BWAQ) were used to measure IA and aggression, respectively. RESULTS: The prevalence of IA and total aggression was 16.8 % and 25.0 %, respectively. Binary logistic regression analysis indicated that IAT score was significantly associated with total and five sub-types of aggression (P < 0.001). However, scores of physical aggression, hostility, and indirect aggression were positively associated with IA (P < 0.001), while verbal aggression and anger were not significant (P > 0.05). Moreover, the interaction of sex and IA was significant for aggression. Specifically, females with IA had higher risks of anger and indirect aggression but had lower risks of physical and verbal aggression compared to males with IA. LIMITATIONS: Cross-sectional design, self-reported information, and only Chinese rural adolescents. CONCLUSIONS: IA is a strong risk factor of total and five sub-types of aggression, while not all sub-types of aggression are predictors of IA. Prevention programs for adolescents' IA and aggression should consider different aggression sub-types and sex.

Relationship between different roles of school bullying and self consciousness among adolescents / 中国学校卫生

Objective@#To explore the relationship between different roles of school bullying and self consciousness among adolescents, and to provide a reference for school bullying prevention and control.@*Methods@#In Ezhou and Xiaogan, two cities selected randomly from Hubei Province, 4 336 middle school students randomly selected from Ezhou and Xiaogan City in Hubei Province by stratified cluster sampling method during March to October in 2017, were investigated for an anonymous questionnaire survey. The Chinese version of adolescent school violence questionnaire was used to evaluate the different roles in school bullying, and the Self Consciousness Scale(SCS) was used to assess the level of self awareness.@*Results@#About 18.9% of the respondents (819) were involved in bullying, among 86(2.0%) were pure perpetrators, 369 (8.5%) were pure victims, 364 (8.4%) were perpetrator victims. There were significant differences in public and private self awareness among different roles of campus bullying ( F=4.05, 2.90, P <0.05). The public self awareness score of perpetrator victims was higher than that of the uninvolved. The private self consciousness score of perpetrator victims was lower than that of the uninvolved ( P <0.05). Multivariate Logistic regression showed a negative correlation between private self awareness and perpetrator victims. Private self awareness might reduce the risk of teenagers becoming perpetrator victims ( OR=0.93, 95%CI =0.91-0.96). A positive correlation between public self awareness and perpetrator victims and public self awareness might increase the risk of adolescents becoming perpetrator victims ( OR=1.08, 95%CI = 1.06- 1.11).@*Conclusion@#Self awareness is related to different roles of school bullying, and higher public self awareness and lower private self awareness are important predictors of perpetrator victims of school bullying.

Redox Mediator: A New Strategy in Designing Cathode for Prompting Redox Process of Li-S Batteries.

The multistep redox reactions of lithium-sulfur batteries involve undesirably complex transformation between sulfur and Li2S, and it is tough to spontaneously fragmentate polysulfides into shorter chains Li2S originating from the sluggish redox kinetics of soluble polysulfide intermediates, causing serious polarization and consumption of sulfur. In this work, 3,4,9,10-perylenetetracarboxylic diimide (PTCDI)/G is employed as sulfur host to accelerate the conversion process between polysulfides and sulfur, which could facilitate the process of both charging and discharging. Moreover, PTCDI has strong adsorption capacity with polysulfides to restrain shuttle effect, resulting in promotional kinetics and cycle stability. A high initial capacity of 1496 mAh g-1 at 0.05 C and slight capacity decay of 0.009% per cycle at 5 C over 1500 cycles can be achieved. Moreover, the cathode could also achieve a high energy efficiency over 85% at 0.5 C. This research extends the knowledge into an original domain for designing high-performance host materials.

Ion-Selective Prussian-Blue-Modified Celgard Separator for High-Performance Lithium-Sulfur Battery.

Application of Li-S batteries has been restricted because of their major problem, that is, shuttling of soluble polysulfides between electrodes, which results in serious capacity fading. For the development of high-performance Li-S batteries, we first time utilize a simple growth method to introduce a Prussian blue (PB)-modified Celgard separator as an ion-selective membrane. The unique structure of PB could effectively suppress the shuttle of polysulfides but scarcely affect the transfer ability of lithium ions, which is beneficial to achieve high sulfur conversion efficiency and capacity retention. The Li-S battery with PB-modified Celgard separator has an average capacity decay of only 0.03 % per cycle at 1 C after 1000 cycles.

A Conductive Ni2 P Nanoporous Composite with a 3D Structure Derived from a Metal-Organic Framework for Lithium-Sulfur Batteries.

Sulfur cathodes have attracted significant attention as next-generation electrode material candidates due to their considerable theoretical energy density. The main challenge in developing long-life Li-S batteries is to simultaneously suppress the shuttle effect and high areal mass loading of sulfur required for practical applications. To solve this problem, we have designed a novel nickel phosphide nanoporous composite derived from metal-organic frameworks (MOFs) as sulfur host materials. Homogeneous distribution of Ni2 P nanoparticles significantly avoids soluble polysulfides migrating out of the framework through strong chemical interactions, and the conductive 3D skeleton offers an accelerating electron transport. As a result, S@Ni2 P/NC has exhibited an enhanced performance of 1357 mAh g-1 initially at 0.2 C (1 C=1675 mA g-1 ) and remaining at 946 mAh g-1 after 300 cycles. Even at an areal mass loading of sulfur as high as 4.6 mg cm-2 , the electrode still showed an excellent specific capacity of 918 mAh g-1 .

Long-Life Lithium-Sulfur Battery Derived from Nori-Based Nitrogen and Oxygen Dual-Doped 3D Hierarchical Biochar.

Due to restrictions on the low conductivity of sulfur and soluble polysulfides during discharge, lithium sulfur batteries are unsuitable for further large scale applications. The current carbon based cathodes suffer from poor cycle stability and high cost. Recently, heteroatom doped carbons have been considered as a settlement to enhance the performance of lithium sulfur batteries. With this strategy, we report the low cost activated nori based N,O-doped 3D hierarchical carbon material (ANC) as a sulfur host. The N,O dual-doped ANC reveals an elevated electrochemical performance, which exhibits not only a good rate performance over 5 C, but also a high sulfur content of 81.2%. Further importantly, the ANC represents an excellent cycling stability, the cathode reserves a capacity of 618 mAh/g at 2 C after 1000 cycles, which shows a 0.022% capacity decay per cycle.

Graphene Aerogels with Anchored Sub-Micrometer Mulberry-Like ZnO Particles for High-Rate and Long-Cycle Anode Materials in Lithium Ion Batteries.

Graphene aerogels (GAs) anchoring hierarchical, mulberry-like ZnO particles are fabricated in situ using a one-step solvothermal reaction. The resulting composites can function as anodes in lithium ion batteries, where they exhibit a high capacity and cyclic stability. The reversible capacities obtained are 365, 320, and 230 mA h g-1 at current densities of 1, 2, and 10 A g-1 . Their high reversible capacity is 445 mA h g-1 at a current density of 1.6 A g-1 ; this value is maintained even after the 500th cycle, The excellent electrochemical performance is attributed to strong oxygen bridges between ZnO and graphene, where C-O-Zn linkages provide a good pathway for electron transport during charge/discharge cycles. Additionally, the hierarchical structure of the ZnO microballs suppresses stacking among the graphene layers, allowing the GAs to accelerate the transport of lithium ions. Furthermore, the GA framework enhances the electrical conductivity and buffer any volume expansion.