内科

目的探究大学生的童年期不良经历（ACEs）与蓄意自伤的关联。方法采用方便抽样法，选取广西壮族自治区12所高校的在校大学生作为调查对象，并利用“问卷星”平台对其进行在线调查，内容包括一般人口学资料、ACEs及蓄意自伤行为。采用多因素logistic回归模型分析大学生ACEs与蓄意自伤之间的关联。结果在1 801名大学生中，自杀企图检出34人，检出率为1.89%，其中独生子女的检出率高于非独生子女（P<0.05）；非自杀性自伤（NSSI）检出70人，检出率为3.89%。在1 801名大学生中，ACEs的检出情况如下：忽视的检出人数最多，共873人（48.47%）；其次是虐待，检出541人（30.04%）；家庭功能不全检出304人（16.88%）；家庭外暴力的检出人数最少，为198人（10.99%）。童年期经历过忽视的大学生的自杀企图检出率高于未经历过者；经历过虐待、家庭功能不全、家庭外暴力的大学生的自杀企图、NSSI检出率均高于未经历过者（均P<0.05）。多因素logistic回归分析显示，独生子女、童年期经历虐待及家庭外暴力是自杀企图的危险因素（均OR>1，均P<0.05）；童年期经历虐待、家庭功能不全、家庭外暴力是NSSI的危险因素（均OR>1，均P<0.05）。结论不同类型的ACEs与大学生蓄意自伤行为发生风险增加相关，建议开展针对性干预。

Objective To explore the association between adverse childhood experiences (ACEs) and deliberate self-harm among college students. Methods The convenience sampling method was used to select undergraduate students from 12 colleges and universities in Guangxi Zhuang Autonomous Region as research subjects. An online survey was conducted through the "Wenjuanxing" platform, covering general demographic data, ACEs, and deliberate self-harm behaviors. A multivariate logistic regression model was used to analyze the association between ACEs and deliberate self-harm among college students. Results Among 1,801 college students, 34 cases of suicide attempt were detected, with a detection rate of 1.89%. The detection rate of suicide attempt among only children was higher than that among non-only children (P<0.05). A total of 70 cases of non-suicidal self-injury (NSSI) were detected, with a detection rate of 3.89%. Among the 1,801 college students, the detection of ACEs was as follows: neglect was the most common, detected in 873 students (48.47%); followed by abuse, detected in 541 students (30.04%); household dysfunction was detected in 304 students (16.88%); and peer, community and collective violence was the least common, detected in 198 students (10.99%). College students who experienced neglect in childhood had a higher detection rate of suicide attempt than those who did not. College students who experienced abuse; household dysfunction; or peer, community and collective violence had higher detection rates of both SA and NSSI than those who did not (all P<0.05). Multivariate logistic regression analysis showed that being an only child; experiencing childhood abuse; and experiencing childhood peer, community and collective violence were risk factors for SA (all OR>1, all P<0.05); while experiencing childhood abuse; household dysfunction; and peer, community and collective violence were risk factors for NSSI (all OR>1, all P<0.05). Conclusion The findings suggest that various ACEs are associated with an increased risk of deliberate self-harm among college students, highlighting the need for targeted interventions.