Prevalence of Adverse Childhood Experiences and Its Associations with Non-Suicidal Self-Injury in Chinese Adolescents with Depression

As a serious public health concern, adverse childhood experiences (ACEs) in adolescents with depression has been associated with a wide range of mental health problems, including non-suicidal self-injury (NSSI). However, few studies have comprehensively explored the prevalence of different types of ACEs and its associations with NSSI in Chinese adolescents with depression. This study aimed to investigate the prevalence of different types of ACEs and its associations with NSSI in Chinese adolescents with depression. 562 depressed adolescents were utilized to assess the prevalence of different types of ACEs and its associations with NSSI, by using Chi-squared tests, latent class analysis (LCA) and multinomial logistic regression. 92.9% of depressed adolescents reported ACEs, in which the prevalence of emotional neglect, physical abuse, caregiver treated violently and bullying were relatively high. Depressed adolescents with NSSI were associated with greater odds of exposure to ACEs, including sexual abuse ( OR  = 5.645), physical abuse ( OR  = 3.603), emotional neglect ( OR  = 3.096), emotional abuse ( OR  = 2.701), caregiver divorce/family separation ( OR  = 2.5), caregiver treated violently ( OR  = 2.221), caregiver substance abuser ( OR  = 2.117). Three latent classes were identified: the high ACEs class (19%), the moderate ACEs class (40%), and the low ACEs class (41%). There had a higher risk of NSSI in the high/moderate ACEs class compared to low ACEs class, particularly in the high ACEs class. The prevalence of ACEs in adolescents with depression was not optimistic, and some types of ACEs was associated with NSSI. Early prevention and targeted intervention of ACEs is important for eliminating potential risk factors for NSSI. In addition, further large-scale longitudinal studies are needed to evaluate the different development trajectories related to ACEs, such as the relationship between different development periods of ACEs and NSSI, and ensure the adoption of evidence-based prevention and intervention strategies.