중국 청소년용 비자살적 자해 신념 척도의 개발 및 타당화

Abstract

This study aims to develop the Nonsuicidal Self-Injury Beliefs Scale for Chinese Adolescents (NSIBS-CA) and assess its feasibility. The scale is designed to capture Positive Self-Injurious Cognitions, Negative Self-Injurious Cognitions, and Facilitating Self-Injurious Cognitions in Chinese adolescents concerning personal and relational contexts. A three-factor model comprising 98 items was developed through a literature review and open-ended questionnaires. Based on pre-survey findings, an Exploratory Factor Analysis was conducted on a sample of 513 Chinese adolescents, resulting in a 20-item, four-factor model. The factors identified were self-injury dependence, relationship benefit, emotion regulation, and negative beliefs. Subsequently, a Confirmatory Factor Analysis was performed on a sample of 1,011 Chinese adolescents, which supported the Exploratory Factor Analysis derived model with 20 items across four sub-factors. To validate the NSIBS-CA, several analyses were conducted. First, the Nonsuicidal Self-Injury Assessment Tool was used to evaluate the NSIBS-CA's convergent validity. A significant positive correlation was observed between the two scales, confirming that the NSIBS-CA measures Nonsuicidal Self-Injury Beliefs. Additionally, a negative correlation between the NSIBS-CA and the Perceived Social Support Scale demonstrated the discriminant validity of the scale. Second, positive correlations were found between the NSIBS-CA and the Feelings of Inadequacy Scale, Difficulties in Emotion Regulation Scale, and Chinese Social Problem Solving Inventory-Revised, indicating criterion-related validity. Third, a one-way ANOVA comparing average scores among groups with no Nonsuicidal Self-Injury(NSSI) thoughts and behaviors, NSSI thoughts, and NSSI behaviors demonstrated group discrimination effectiveness. To evaluate predictive validity, a logistic regression analysis was conducted to examine the relationship between the NSIBS-CA and self-injury, revealing that the scale can primarily predict NSSI behaviors. Lastly, to establish incremental validity, a hierarchical regression analysis was performed using self-injury frequency and the likelihood of future self-injury as criterion variables. The results indicated that the NSIBS-CA accounts for a significant proportion of explained variance. The primary aim of this study is to develop a scale specifically tailored to assess NSIBS-CA and elucidate the factors contributing to the onset and recurrence of NSSI behaviors. Furthermore, the scale can be utilized to assess general beliefs, regardless of the presence or absence of NSSI experiences, serving as a valuable tool for self-injury prevention and early intervention. Based on the study's findings, several recommendations and implications for future research are discussed.