Association between parenting and non-suicidal self-injury among adolescents in Yunnan, China: a cross-sectional survey

BACKGROUND: Non-suicidal self-injury (NSSI) among adolescents is prevalent and its rate has increased in recent years worldwide. Previous studies had investigated the association between parenting and childhood NSSI, but little is known about the relationship between parental rearing and repetition and severity of NSSI. The aim of this study was to investigate associations of parenting with NSSI and its repetition and severity in a representative adolescent sample from southwestern China. METHODS: In this cross-sectional study, a sample of 2,705 adolescents (F/M: 1,245/1,460; mean age: 13.4 ± 2.2 years) was recruited from 14 randomly selected schools in Lincang municipality, Yunnan province, China. A self-report questionnaire was used to collect data. The Adolescent Non-Suicidal Self-Injury Function Assessment Scale and the short Chinese Egna Minnen av Barndoms Uppfostran (s-EMBU-C) were used to evaluate NSSI behaviors and parenting style, respectively. Univariate and multivariate logistic regression models were adopted to examine association between parenting and NSSI. RESULTS: Overall lifetime prevalence of NSSI was 47.1% (95% CI [36.2–58.0]), with self-cutting being the most common form (23.5% (95% CI [19.3–27.7])), followed by hitting hard objects (23.4% (95% CI [20.2–26.7])) and pulling hairs (20.9% (95% CI [18.8–22.6])). In multiple logistic regression analyses, NSSI was positively associated with high level of father’s rejection (OR: 1.32 (95% CI [1.01–1.72])), high level of mother’s rejection (OR: 1.76 (95% CI [1.46–2.13])), low level of mother’s emotional warmth (OR: 1.42 (95% CI [1.15–1.75])), and high level of mother’s overprotection (OR: 1.74 (95% CI [1.49–2.03])), repeated NSSI was positively associated with low level of father’s emotional warmth (OR: 1.39 (95% CI [1.10–1.75])) and high level of mother’s overprotection (OR: 1.79 (95% CI [1.33–2.41])), and severe NSSI was positively associated with low level of father’s emotional warmth (OR: 1.64 (95% CI [1.11–2.43])) and high level of mother’s rejection (OR: 2.16 (95% CI [1.71–2.71])). CONCLUSION: NSSI is common among adolescents in southwestern China. Negative parenting styles are associated with NSSI, repeated NSSI, and severe NSSI. The development of intervention measures for preventing or reducing NSSI among Chinese adolescents in school settings should consider parenting styles.