Deliberate self-harm among Chinese medical students: A population-based study.
The phenomenon of deliberate self-harm (DSH) among college students has received increased attention in recent decades. Adopting a psychosocial perspective, this study aims to describe self-reported DSH among Chinese medical college students, assess respective associations between uncertainty stress and social capital with DSH, and explore the mechanism linking these three phenomena.



A cross-sectional survey employing multi-stage, sampling was conducted. 4446 undergraduate students were recruited from 22 participating Chinese medical universities. Perceived stress from uncertainty and social capital were assessed among the students. The Chi-square test and multiple logistic regression models assessed correlates of DSH. Relationship among social capital, uncertainty stress, and DSH were examined by means of Structural Equation Modeling.



The prevalence of DSH in the past 12 months among Chinese students was 9.6%. The most common types of physical DSH reported were scratching, cutting, and pinching. Age (χ(2)=26.63, p<0.01), gender (χ(2)=30.24, p<0.01), major field (χ(2)=28.13, p<0.01), and annual household income (χ(2)=11.10, p<0.05) were statistically associated with DSH. Uncertainty stress is a unique correlate of DSH, and shows a stronger association than do three certainty stressors. Social capital is also a strong correlate of DSH, especially cognitive social capital. Moreover, social capital may be indirectly associated with DSH through impacting uncertainty stress.



This study was a cross-sectional and thus could not evaluate causal relationships.



We recommend that a DSH intervention study should target uncertainty stress management and social capital accumulation. This study provides scientific evidence and theoretical foundation for future DSH interventions, with a view to enhancing the mental health of medical college students.
Department of Psychology, School of Humanities and Management, Guangdong Medical University, Dongguan, Guangdong 523808, China.
Dan
D
Wu
Injury Control Research Center and Department of Epidemiology, School of Public Health,West Virginia University, Morgantown, WV 26506, USA.
Ian R H
IR
Rockett
Department of Social Medicine/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China. Electronic address: tingzhongyang@zju.edu.cn.
Tingzhong
T
Yang
Department of Social Medicine/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.
Xueying
X
Feng
Department of Social Medicine/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.
Shuhan
S
Jiang
Department of Social Medicine/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.
Lingwei
L
Yu
D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012931:Social Environment; D013315:Stress, Psychological; D013337:Students, Medical / Q000523:psychology*; D035501:Uncertainty; D055815:Young Adult
Deliberate self-harm; Medical college students; Population-based study; Social capital; Uncertainty stress