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Association of Unhealthy Behaviors with Self-Harm in Chinese Adolescents: A Study Using Latent Class Analysis

by 1,2,3,4,†, 1,2,3,5,†, 6, 1,2,3, 1,2,3, 1,2,3, 1,2,3, 1,2,3,7,8,* and 1,2,3,*
1
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
2
MOE Key Laboratory of Population Health Across Life Cycle, Hefei 230032, China
3
Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
4
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
5
School of Public Health, Medical College of Soochow University, Suzhou 215123, China
6
Department of Occupational and Environmental Health, School of public health, Guilin Medical University, Guilin 541199, China
7
Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
8
Faculty of Pharmaceutical Science, Sojo University, Ikeda 4-22-1, Kumamoto 860-0082, Japan
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Received: 24 March 2021 / Revised: 15 July 2021 / Accepted: 22 July 2021 / Published: 26 July 2021
Previous studies have demonstrated the link between individual unhealthy behaviors and self-harm, but little is known about the influence of multiple unhealthy behaviors on self-harm among adolescents. This study aims to identify the potential patterns of unhealthy behaviors and to examine their associations with self-harm, which may become a useful tool for the screening of self-harm in adolescents. A total of 22,628 middle school students (10,990 males and 11,638 females) in six cities was enrolled in this study by multistage stratified cluster sampling from November 2015 to January 2016. Latent class analysis (LCA) was performed based on five kinds of unhealthy behaviors (unhealthy losing weight (ULW), tobacco use (TU), alcohol use (AU), screen time (ST), and mobile phone dependence (MPD)). Multivariate logistic regressions were used to examine associations between identified subgroups and self-harm. Four subgroups of unhealthy behaviors were identified. Class 1 (71.2%) had the lowest engagement in unhealthy behaviors. Class 2 ((ULW/MPD), 22.3%) had a relatively high prevalence of ULW and MPD. Class 3 ((TU/AU/ST), 3.2%) had a relatively high prevalence of TU, AU, and ST. Class 4 (3.3%) consistently engaged in unhealthy behaviors. Compared to class 1, class 2 (ULW/MPD), class 3 (TU/AU/ST), and class 4 showed OR (95%CI) values of 2.101 (1.964–2.248), 2.153 (1.839–2.520), and 3.979 (3.407–4.645) (p < 0.001 for each), respectively. Class 1, class 2 (ULW/MPD), and class 3 (TU/AU/ST) engagement in unhealthy behaviors was associated with increased self-harm. These findings strongly suggested that self-harm prevention efforts focusing on multiple unhealthy behaviors should be seriously considered for early detection of self-harm. View Full-Text
Keywords: unhealthy behaviors; latent class analysis; self-harm; adolescents unhealthy behaviors; latent class analysis; self-harm; adolescents
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MDPI and ACS Style

Yang, R.; Li, D.; Tian, R.; Hu, J.; Xue, Y.; Huang, X.; Wan, Y.; Fang, J.; Zhang, S. Association of Unhealthy Behaviors with Self-Harm in Chinese Adolescents: A Study Using Latent Class Analysis. Trauma Care 2021, 1, 75-86. https://0-doi-org.brum.beds.ac.uk/10.3390/traumacare1020008

AMA Style

Yang R, Li D, Tian R, Hu J, Xue Y, Huang X, Wan Y, Fang J, Zhang S. Association of Unhealthy Behaviors with Self-Harm in Chinese Adolescents: A Study Using Latent Class Analysis. Trauma Care. 2021; 1(2):75-86. https://0-doi-org.brum.beds.ac.uk/10.3390/traumacare1020008

Chicago/Turabian Style

Yang, Rong, Danlin Li, Run Tian, Jie Hu, Yanni Xue, Xuexue Huang, Yuhui Wan, Jun Fang, and Shichen Zhang. 2021. "Association of Unhealthy Behaviors with Self-Harm in Chinese Adolescents: A Study Using Latent Class Analysis" Trauma Care 1, no. 2: 75-86. https://0-doi-org.brum.beds.ac.uk/10.3390/traumacare1020008

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