青少年非自杀性自伤与家庭复原力的关系：一项有调节的中介效应研究

BackgroundAdolescents with immature mind and unstable emotional control are high-risk groups of non-suicidal self-injury (NSSI) behavior. We meta-analyzed the global prevalence of NSSI and prevalence of NSSI characteristics in a non-clinical sample of adolescents between 2010 and 2021.MethodsA systematic search for relevant articles published from January 1, 2010 to June 30, 2021 was performed within the scholarly database search engines of CBM, CNKI, VIP, Wanfang, PubMed, Web of Science, PsycINFO, and Embase. Eligibility criteria were as follows: provided cross-sectional data on the prevalence of NSSI; the subjects were non-clinical sample adolescents; and a clear definition of NSSI was reported. We used the following definiton of NSSI as our standard: the deliberate, self-inflicted destruction of body tissue, such as cutting, burning, and biting, without attempted suicide. The quality evaluation tool for cross-sectional studies recommended by the JBI was used. The global prevalence of NSSI was calculated based on the random-effects model by Comprehensive Meta-analysis version 3.0. Subgroup analyses were performed to compare the prevalence according to sex, living place, smoking or drinking history, and family structure.ResultsSixty-two studies involving 264,638 adolescents were included. The aggregate prevalence of NSSI among a non-clinical sample of adolescents was similar between over a lifetime (22.0%, 95% CI 17.9–26.6) and during a 12-month period (23.2%, 95% CI 20.2–26.5). Repetitive NSSI was more common than episodic NSSI (20.3% vs. 8.3%) but the frequency of mild injury (12.6%) was similar to that of moderate injury (11.6%). Multiple-method NSSI occurred slightly more often compared than one-method NSSI (16.0% vs. 11.1%). The top three types of NSSI in adolescents were banging/hitting (12.0%, 95% CI 8.9–15.9), pinching (10.0%, 95% CI 6.7–14.8), and pulling hair (9.8%, 95% CI 8.3–11.5), and the least common type was swallowing drugs/toxic substances/chemicals (1.0%, 95% CI 0.5–2.2). Subgroup analyses showed that being female, smoking, drinking, having siblings, and belonging to a single-parent family may be linked to higher prevalence of NSSI.ConclusionThis meta-analysis found a high prevalence of NSSI in non-clinical sample of adolescents, but there are some changes in severity, methods, and reasons. Based on the current evidence, adolescents in modern society are more inclined to implement NSSI behavior by a variety of ways, which usually are repetitive, and moderate and severe injuries are gradually increasing. It is also worth noting that adolescents with siblings or in single-parent families are relatively more likely to implement NSSI behavior due to maladjustment to the new family model. Future research needs to continue to elucidate the features and risk factors of NSSI so as to intervene in a targeted way.LimitationThe limitation of this study is that the heterogeneity among the included studies is not low, and it is mainly related to Chinese and English studies. The results of this study should be used with caution.Systematic review registration[www.crd.york.ac.uk/prospero/], identifier [CRD42022283217].

Fertility concerns, fear of cancer recurrence, social support, and self-efficacy are key factors that influence family resilience in adolescents and young adults with cancer. However, their combined effects and underlying mechanisms remain unclear. This study constructed a structural equation model to examine these relationships and provide evidence for the development of targeted psychosocial interventions in clinical practice. A cross-sectional survey was conducted from April 2024 to March 2025 using convenience sampling of 259 adolescents and young adults with cancer at a tertiary-level specialized cancer hospital in Hunan Province. All the participants completed validated measures of fertility concerns, fear of cancer recurrence, social support, self-efficacy, and family resilience. A structural equation model was constructed using the AMOS software to test the hypothesized pathways. Correlation analysis revealed significant associations between all variables. The structural equation model demonstrated good fit. Path analysis revealed that fertility concerns and fear of recurrence exerted significant negative effects on family resilience, while social support and self-efficacy exerted significant positive effects. Further analysis revealed that social support and self-efficacy partially mediated the relationships between fertility concerns, fear of cancer recurrence, and family resilience. Family resilience among adolescent and young adult patients with cancer was significantly associated with fertility concerns, fear of cancer recurrence, social support, and self-efficacy. Social support and self-efficacy can mitigate and mediate the negative effects of fertility concerns and the fear of cancer recurrence on family resilience. Therefore, future clinical interventions should prioritize enhancing social support and self-efficacy among adolescents and young adults with cancer to alleviate fertility concerns and fear of cancer recurrence, thereby strengthening family resilience.

Introduction: Weight bias internalization (WBI) is associated with reduced psychological well-being in individuals with obesity. The aim of this study was to investigate the application of Cohen’s stress-buffering model of social support for WBI on well-being in patients presenting for bariatric surgery. Methods: In N = 804 adult prebariatric patients, WBI, social support, depression severity, health-related quality of life (HRQOL), and self-esteem were assessed by self-report questionnaires. Structural Equation Modeling was applied to test for direct associations between social support and well-being and for a buffering effect of social support on the relationship between WBI and well-being. Results: After controlling for age, sex, and body mass index, greater social support was directly associated with reduced depression severity and increased self-esteem, but not with increased HRQOL. Contrary to Cohen’s stress-buffering model, social support showed no moderating effects on the association between WBI and depression severity, HRQOL, and self-esteem. Conclusion: These cross-sectional results may indicate that greater social support is associated with improved well-being, supporting it as a potential coping resource in bariatric surgery. Given the absence of supporting evidence for the buffering effect in the present study, future prospective research may reevaluate the existence of a moderating effect of social support and investigate whether support-focused interventions improve psychological well-being.

Background: Few studies have examined correlates of deliberate self-harm (DSH) among African-Americans. Moreover, most research on the correlates of DSH in general has focused on risk factors rather than protective factors.Aims: This study examined differences in perceived social support, religiosity (both spirituality and church attendance) and overall life satisfaction between African-Americans with and without a history of DSH, as well as the moderating roles of gender and sexual orientation in these relations.Method: Participants were 244 African-American university students who completed questionnaires.Results: Participants with (vs. without) DSH reported significantly lower levels of social support. Additionally, rates of DSH were significantly higher among participants who attended church irregularly versus regularly or rarely/never. However, the association between DSH and church attendance was significant only for women (vs. men) and LGBQ (vs. heterosexual) women. Further, gender moderated the relation between DSH and social support from both significant others and friends, with self-harming women (but not men) reporting less support than their non-DSH counterparts.Conclusions: Findings add to the literature on DSH among African-Americans, highlighting both social support and church attendance (depending on regularity) as potential protective factors within this population.

According to the Theory of Change, the resilience of the family unit plays a crucial role in shaping the developmental trajectory of children. Families exhibiting higher levels of family resilience are typically characterized by transparent and effective communication, optimistic outlooks on adversity, adept problem-solving skills, strong spiritual beliefs, and effective management of social and financial resources. While existing research has indicated that parental and familial characteristics can predict diverse outcomes for children, investigations concerning the association between family resilience and children's subjective well-being remains limited. Therefore, this study aims to examine whether different dimensions of family resilience can predict changes in children's subjective well-being, tested one year later. The sample includes 762 child-mother-father triads (intact families). Children aged 9-13 years (48% boys, age = 11.04, SD = 1.16) assessed their life satisfaction, positive and negative affect in two study waves, while mothers and fathers assessed family resilience in the first wave. A dyadic data common fate model was employed to create latent variables representing family resilience. Three latent variables were: family problem-solving, family spirituality, and utilization of social and economic resources. Findings from the structural equation model indicated a positive association between higher levels of family problem-solving and increased children's life satisfaction, alongside a negative relationship between higher family spirituality and negative affect. Parental assessments of social and economic resources utilization were not uniquely related to children's life satisfaction, positive, or negative affect.

Relationship between caregiver burden and family resilience among Chinese parents of children with autism spectrum disorder: The mediating role of social support and positive cognition.

Adolescents with type 1 diabetes (T1D) often experience heightened levels of diabetes distress and struggle with maintaining effective self-management behavior. Resilience-both at the family and individual levels-is a crucial psychological capacity for coping with challenges. However, limited research has explored how diabetes distress, family resilience, self-resilience, and self-management behavior are interrelated in adolescents with T1D. The purpose of this study was to examine whether family resilience and self-resilience mediate the association between diabetes distress and self-management behavior in adolescents with T1D. A cross-sectional study was conducted in a children's hospital in China, involving 143 adolescents with T1D (mean age=13.05 years) and their caregivers. Participants completed the Diabetes Behavior Rating Scale, Problem Areas in Diabetes Scale, Diabetes Strengths and Resilience measure for adolescents, and Family Resilience Assessment Scale. Structural equation modeling was employed for data analysis. Diabetes distress was negatively associated with family resilience, self-resilience, and self-management behavior. Family resilience, self-resilience, and self-management behavior were positively correlated. Both family resilience and self-resilience significantly and partially mediated the association between diabetes distress and self-management behavior. These findings highlight that family and individual resilience partly buffer the adverse effects of diabetes distress on self-management. Interventions should support families in recognizing and leveraging their strengths, while incorporating resilience-enhancing strategies to promote both psychological well-being and self-management in adolescents with T1D.

Although nonsuicidal self-injury (NSSI) peaks in adolescence, a significant proportion of young people continue to self-injure into emerging adulthood. Yet, little is known about factors prospectively associated with persistent NSSI. Using data from a 3-year longitudinal study (n = 1466), we compared 51 emerging adults (67.3% female; average age, 20.0 years) who continued to self-injure from adolescence and 50 emerging adults (83.7% female; average age, 20.3 years) who had ceased NSSI, on a broad range of psychosocial factors. More frequent NSSI, use of a greater number of methods, specific NSSI functions, academic and emotional distress, and lack of perceived emotion regulatory capability differentiated emerging adults who continued with NSSI and those who had ceased the behavior. Further, the relationships between social support, life satisfaction, and NSSI were mediated by perceived ability to regulate emotion. Findings from this study point to the role of personal belief in the ability to effectively regulate emotion in the cessation of NSSI. Future research directions and clinical implications are discussed.

This study aims to understand the relationship between psychological resilience and social support in family resilience and demoralization syndrome (DS) in decompensated cirrhotic patients and verify whether there is a parallel mediation effect. A cross-sectional design was adopted, and a questionnaire was administered to 260 patients with decompensated cirrhosis in Jinan, Shandong Province, China. The Mandarin Version of the Demoralization Scale (DS-MV) was used to assess DS. Spearman's correlation was used to analyze the relationship between family resilience, DS, psychological resilience, and social support, and predictors of DS were explored using multiple linear regression. Parallel mediation effect analysis was performed using a bootstrap test. The proportion of patients with severe DS was 18.46% of those with decompensated cirrhosis. Spearman correlation analysis demonstrated that DS was negatively correlated with psychological resilience, family resilience, and social support (r = -0.738, p < 0.01; r = -0.668, p < 0.01; r = -0.405, p < 0.01). Multiple linear regression analysis showed that psychological resilience (β = -0.477, p < 0.001), family resilience (β = -0.364, p < 0.001), and social support (β = -0.108, p = 0.01) could influence DS of decompensated cirrhotic patients. Bootstrap analysis confirmed a significant parallel mediation effect of psychological resilience and social support (95% CI: -0.999 to -0.499), accounting for 51.93% of the total effect. Family resilience had a significant direct effect (95% CI: -0.995 to -0.356), accounting for 48.07% of the total effect. Therefore, attention should be paid to DS in decompensated cirrhotic patients. Family resilience, psychological resilience, and social support can be used to decrease the level of DS.

ObjectiveThis study analyzes the relationship between family resilience, social support, and family function of elderly patients with COPD. It explores the mediating effect of family resilience between social support and family function and the influence path among them, so as to provide evidence for medical staff to formulate targeted intervention measures and improve family function of elderly patients with COPD.MethodsUsing a convenience sampling, 535 elderly patients with COPD were recruited in the respiratory and critical care departments of six tertiary hospitals in Ningxia, China from August 2022 to September 2023. The participants were assessed by general information questionnaire, family resilience assessment scale, social support assessment scale, family density, and adaptability scale. Pearson correlation analysis was used to evaluate the correlation between variables, and Model 4 in PROCESS 4.2 plugin was used to explore the mediating role of family resilience in the relationship between social support and family function.ResultsPearson correlation analysis showed that family function was positively correlated with social support (r = 0.406, p < 0.001) and family resilience (r = 0.622, p < 0.001), and family resilience was also positively correlated with social support (r = 0.361, p < 0.001). Mediation analysis revealed that social support was directly associated with family function (β = 0.556, 95%CI = 0.371, 0.741). Additionally, social support can also indirectly associated with family function via the mediation of family resilience (β = 0.526, 95%CI = 0.378, 0.672). The direct effect accounts for 51.39% of the total effect and the indirect effect accounts for 48.61% of the total effect.ConclusionFamily resilience plays a partial mediating role in social support and family function of elderly patients with COPD, and medical staff should pay attention to the integration of social support intervention and family resilience intervention to better improve family function of patients.

It is well known that the experience of victimization often leads to adverse health and behavioral outcomes in adolescents. However, less is known about why victimization results in such outcomes for some youth and not others. One possible explanation is the presence or absence of social support networks in an individual's life influence the effects of strain. Because youth are often less equipped to deal with stress and other negative emotions caused by strain, having positive sources to draw support from could prove beneficial (Agnew, 2002; Miller, Fagan, &amp; Wright, 2014). Drawing from general strain theory and its proposed conditioning hypothesis, the current study used two ordinary least square regressions to examine the moderating effect of social support on the relationship between victimization and two common forms of adolescent maladjustment: psychological distress and delinquency. Using data from NatSCEV III, analyses were conducted with a subsample of adolescents ages 10 to 17 (n = 1,957). Results showed that family social support significantly moderated the relationship between victimization and psychological distress, but not the victimization-delinquency relationship. To further test this moderating effect, a median-split was used. Results indicated that high family social support moderated the relationship between victimization and psychological distress. No moderating effect of friend social support was found.

We use the Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to investigate the framework's core concept of family resilience and related protective and promotive factors that contribute to greater resilience, namely communication. Scant research has examined communication in Indigenous families; yet general research suggests that family communication is a prominent aspect of family resilience. In this exploratory sequential mixed-methods study with data from 563 Indigenous participants (n = 436 qualitative and n = 127 quantitative survey), thematic reconstructive analysis was used to qualitatively understand participants' experiences of family communication and quantitatively examine protective factors for family resilience. The following themes related to family communication as a component of family resilience emerged from qualitative analysis: "It's in the Family Circle": Discussing Problems as a Family with the subtheme: Honesty between Partners; (b) "Never Bring Adult Business into Kids' Lives": Keeping Adult Conversations Private; and (c) "Trust Us Enough to Come to Us": Open Communication between Parents and Children. Regression analysis indicated that higher community and social support, relationship quality, and life satisfaction were associated with greater family resilience. Positive communication practices are a strong component of resilience, healthy Indigenous families. Promotive factors at the community (social and community support), relational (relationship quality), and individual (life satisfaction) levels positively contribute to Indigenous family resilience. Clinical programs providing practical tools to foster healthy communication - both about difficult topics as well as positive topics - are promising avenues to foster resilience.

Associations Among Gender-Affirming Hormonal Interventions, Social Support, and Transgender Adolescents' Mental Health

The end of a person's working life presents a new challenge as they enter old age. The issues faced by retirees can affect family resilience. This study aims to analyze the influence of family interaction, social support, and coping strategies on family resilience after retirement. The research used a quantitative approach with a cross-sectional study design and purposive sampling method. The study involved 40 families with husbands who had retired within the past three years, were married, and had children, all residing in Cibinong District, Bogor Regency. The results showed that family interaction, social support, and coping strategies were at a moderate level, while family resilience was at a high level. Correlation tests revealed a significant positive relationship between the wife's age and family interaction, a significant negative relationship between the husband's education and social support, and a significant positive relationship between family interaction and social support. Multiple linear regression analysis showed a significant positive influence of the wife's age on family resilience. The husband's age and education had a significant negative influence on family resilience, while family income had a significant positive influence. Nuclear family support and the self-control dimension had a positive effect on family resilience. Meanwhile, the escape-avoidance and planful problem-solving dimensions had a significant negative effect on family resilience. Therefore, efforts are needed by families to maintain effective communication, enhance social support, and practice good emotional management in post-retirement family life.

BackgroundChildhood maltreatment has been consistently associated with nonsuicidal self-injury (NSSI). Patients with bipolar disorder (BD) are especially vulnerable to early adversity and self-injurious behaviors; however, the mechanisms underlying this association remain unclear. Among Chinese patients with BD, this study tested whether dysfunctional attitudes mediate the association between childhood maltreatment and NSSI and whether social support moderates this association.MethodsA cross-sectional study was conducted with 838 clinically diagnosed bipolar disorder patients (68.1% female; median age = 16 years). Measures included the Childhood Trauma Questionnaire–Short Form (CTQ-SF), Dysfunctional Attitudes Scale (DAS-A), Social Support Rating Scale (SSRS), Ottawa Self-Injury Inventory–Chinese Revised Edition (OSIC), and Hamilton Depression Rating Scale (HAMD-24). Descriptive analyses, correlations, mediation, and moderated mediation models were tested using SPSS 26.0 and Mplus 8.3, with robust maximum likelihood estimation (MLR) and 5,000 bootstrap resamples.ResultsIn our clinical sample of patients with bipolar disorder, 68.5% reported nonsuicidal self-injury (NSSI). Childhood maltreatment was positively associated with both dysfunctional attitudes and NSSI. Mediation analysis demonstrated that dysfunctional attitudes partially mediated the association between childhood maltreatment and NSSI (indirect effect β = 0.040, 95% CI [0.017, 0.061], p < 0.01), accounting for 18.2% of the total effect. Moderation analysis further indicated that social support significantly attenuated the association between dysfunctional attitudes and NSSI (interaction β = –0.082, 95% CI [–0.162, –0.015], p < 0.05), but did not moderate the associations of childhood maltreatment with either dysfunctional attitudes or NSSI.ConclusionChildhood maltreatment increases the risk of NSSI in patients with BD both directly and indirectly through dysfunctional attitudes, while social support mitigates the behavioral impact of dysfunctional attitudes on NSSI. These findings highlight dysfunctional attitudes as a cognitive mechanism and social support as a conditional protective factor, underscoring the importance of childhood maltreatment screening, cognitive restructuring, and support-enhancing interventions in reducing NSSI risk among Chinese patients with bipolar disorder.