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 ideationonly, 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.