@article{ref1,
title="Contextual influences on deliberate self-harm among Chinese university undergraduates: a representative nationwide study",
journal="Journal of affective disorders",
year="2023",
author="Peng, Sihui and Zhang, Weifang and Yang, Tingzhong and Cottrell, Randall R. and Rockett, Ian R. H.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Numerous studies have identified factors associated with deliberate self-harm (DSH), but environmental influences have largely been neglected. This study explored regional and university contextual factors that impact DSH among undergraduate students in China. <br><br>METHODS: Subjects in this observational cross-sectional study totaled 5016 undergraduate students, who were identified through multistage survey sampling in 22 Chinese universities. Individual-level data were obtained through a self-administered questionnaire, and environmental variables were extracted from the National Bureau of Statistics database. Multilevel logistic regression models were used to examine regional correlates of DSH. <br><br>RESULTS: The overall prevalence of self-reported DSH in the study sample was 7.5 % (95 % CI: 4.1 %, 10.9 %). The full multilevel logistic model showed university rank and city size were inversely associated with DSH prevalence (Adjusted Odds Ratio (AOR): 0.24 and 0.55). Regional unemployment rates were positively associated with DSH prevalence (AOR: 1.98, 95 % CI: 1.48, 2.65). <br><br>DISCUSSION: Contextual disparities appear to contribute to DSH among Chinese undergraduates. Preventive initiatives must focus on redressing imbalances in the allocation of social and economic resources across universities and regions.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2023.05.010",
url="http://dx.doi.org/10.1016/j.jad.2023.05.010"
}