{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:30:17Z","timestamp":1787499017419,"version":"build-2736575974"},"reference-count":44,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T00:00:00Z","timestamp":1599523200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Yunnan Applied Basic Research Projects-Kunming Medical University Union Foundation","award":["2018FE001(-132)"],"award-info":[{"award-number":["2018FE001(-132)"]}]},{"name":"Top Young Talents of Yunnan Ten Thousand Talents Plan","award":["YNWR-QNBJ-2018-286"],"award-info":[{"award-number":["YNWR-QNBJ-2018-286"]}]},{"name":"Innovative Research Team of Yunnan Province","award":["2019(6)"],"award-info":[{"award-number":["2019(6)"]}]},{"name":"Yunnan Health Training Projects of Highly Level Talents","award":["D-2017048"],"award-info":[{"award-number":["D-2017048"]}]},{"name":"Research Project of Medical and Sanitary Institution of Yunnan Province","award":["2018NS0110"],"award-info":[{"award-number":["2018NS0110"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Abundant studies have identified the association between childhood maltreatment and self-harm (SH), but little has been discussed with regard to the role of resilience in SH behaviors of adolescents who had experienced childhood maltreatment. In this study, we investigated if resilience, as well as its five dimensions, could present negative associations with presence, repetition, and severity of SH among maltreated and neglected adolescents in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey including 2,084 maltreated teenagers aged from 10 to 17 years was conducted in southwest China Yunnan province. The Childhood Trauma Questionnaire (CTQ), The Resilience Scale for Chinese Adolescents (RSCA), and the Modified version of Adolescents Self-Harm Scale (MASHS) were adopted to measure childhood maltreatment experiences, psychological resilience, and SH behaviors of the respondents, respectively. Binary univariate and multivariate logistic regression models were employed to discuss the associations between resilience and occurrence, repetition, severity of SH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the participants who met the criteria of CTQ, the prevalence rates of SH were 63.83%, 73.94%, 71.50%, 55.53%, and 58.21% for physical abuse (PA), emotional abuse (EA), sexual abuse (SA), physical neglect (PN), and emotional neglect (EN). Final regression model demonstrated that resilience was in general inversely associated with SH, repeated SH, and severe SH for all types of childhood maltreatment, with adjusted odds ratios (aORs) ranging from 0.29 (95% CI: 0.19-0.44) to 0.46 (95% CI: 0.26-0.81). Of the five dimensions of resilience, emotion regulation served as the strongest associated factor of SH among abused youths, regardless of maltreatment types. Besides, compared with those who had lower level of goal concentration and interpersonal assistance, subjects with higher resilience level reported significantly decreased risks of SH occurrence, SH repetition, and more severe SH, in adolescents who had experienced EA and PN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Resilience showed inverse association with childhood maltreatment related SH in Chinese adolescents. These findings preliminarily indicated that interventions targeting on building up resilience, especially enhancing emotion regulation ability, improving goal concentration, and consolidating interpersonal assistance, could be effective in reducing SH risk, repetition, and severity in maltreated Chinese teenagers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.9800","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T04:27:10Z","timestamp":1599539230000},"page":"e9800","source":"Crossref","is-referenced-by-count":13,"title":["Resilience is inversely associated with self-harm behaviors among Chinese adolescents with childhood maltreatment"],"prefix":"10.7717","volume":"8","author":[{"given":"Xin","family":"Tian","sequence":"first","affiliation":[{"name":"School of Public Health, Kunming Medical University, Kunming, China"},{"name":"The First Affiliated Hospital, Kunming Medical University, Kunming, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangya","family":"Yang","sequence":"additional","affiliation":[{"name":"Lincang Psychiatry Hospital, Lincang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linling","family":"Jiang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital, Kunming Medical University, Kunming, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runxu","family":"Yang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital, Kunming Medical University, Kunming, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailiang","family":"Ran","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University, Kunming, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fujia","family":"Xie","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital, Kunming Medical University, Kunming, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiufeng","family":"Xu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital, Kunming Medical University, Kunming, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Lu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital, Kunming Medical University, Kunming, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Xiao","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University, Kunming, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2020,9,8]]},"reference":[{"issue":"5","key":"10.7717\/peerj.9800\/ref-1","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.amepre.01.005","article-title":"Adverse childhood experiences and prescribed psychotropic medications in adults","volume":"32","author":"Anda","year":"2007","journal-title":"American journal of preventive medicine"},{"key":"10.7717\/peerj.9800\/ref-2","volume-title":"Childhood trauma questionnaire: a retrospective self report manual","author":"Bernstein","year":"1998"},{"issue":"2","key":"10.7717\/peerj.9800\/ref-3","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/s0145-2134(02)00541-0","article-title":"Development and validation of a brief screening version of the Childhood Trauma Questionnaire","volume":"27","author":"Bernstein","year":"2003","journal-title":"Child Abuse and Neglect"},{"issue":"4","key":"10.7717\/peerj.9800\/ref-4","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1192\/bjp.bp.115.170050","article-title":"Predicting suicide following self-harm: systematic review of risk factors and risk scales","volume":"209","author":"Chan","year":"2016","journal-title":"The British Journal of Psychiatry"},{"issue":"3","key":"10.7717\/peerj.9800\/ref-5","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1080\/15299732.2015.989647","article-title":"The roles of emotion dysregulation and dissociation in the association between sexual abuse and self-injury among juvenile justice-involved youth","volume":"16","author":"Chaplo","year":"2015","journal-title":"International Society for the Study of Dissociation"},{"issue":"6","key":"10.7717\/peerj.9800\/ref-6","doi-asserted-by":"publisher","first-page":"821","DOI":"10.4088\/JCP.11m07250","article-title":"A longitudinal study of non-suicidal self-injury in offspring at high risk for mood disorder","volume":"73","author":"Cox","year":"2012","journal-title":"The Journal of Clinical Psychiatry"},{"issue":"1","key":"10.7717\/peerj.9800\/ref-7","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1023\/a:1007835531614","article-title":"Intimacy dysfunction and trauma symptomatology: long-term correlates of different types of child abuse","volume":"14","author":"Davis","year":"2001","journal-title":"Journal of Traumatic Stress"},{"issue":"1","key":"10.7717\/peerj.9800\/ref-8","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1111\/j.1467-8624.2004.00652.x","article-title":"The relations of effortful control and impulsivity to children\u2019s resiliency and adjustment","volume":"75","author":"Eisenberg","year":"2004","journal-title":"Child Development"},{"issue":"8","key":"10.7717\/peerj.9800\/ref-9","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1016\/S0191-8869(00)00220-8","article-title":"The crisis support scale: psychometric qualities and further validation","volume":"31","author":"Elklit","year":"2001","journal-title":"Personality and Individual Differences"},{"issue":"3","key":"10.7717\/peerj.9800\/ref-10","doi-asserted-by":"publisher","first-page":"176","DOI":"10.2471\/BLT.14.140970","article-title":"The burden of child maltreatment in China: a systematic review","volume":"93","author":"Fang","year":"2015","journal-title":"Bulletin of the World Health Organization"},{"key":"10.7717\/peerj.9800\/ref-11","article-title":"The relation of adolescents\u2019 self-harm behaviors, individual emotion characteristics and family environment factors. Jiang G","author":"Feng","year":"2008","journal-title":"Thesis"},{"key":"10.7717\/peerj.9800\/ref-12","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1192\/bjp.175.2.175","article-title":"Risk factors for suicide independent of DSM-III-R Axis I disorder. Case-control psychological autopsy study in Northern Ireland","volume":"175","author":"Foster","year":"1999","journal-title":"The British Journal of Psychiatry"},{"issue":"9657","key":"10.7717\/peerj.9800\/ref-13","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/S0140-6736(08)61706-7","article-title":"Burden and consequences of child maltreatment in high-income countries","volume":"373","author":"Gilbert","year":"2009","journal-title":"Lancet"},{"issue":"1","key":"10.7717\/peerj.9800\/ref-14","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s12888-018-1607-0","article-title":"A self-harm series and its relationship with childhood adversity among adolescents in mainland China: a cross-sectional study","volume":"18","author":"Han","year":"2018","journal-title":"BMC Psychiatry"},{"issue":"9834","key":"10.7717\/peerj.9800\/ref-15","doi-asserted-by":"publisher","first-page":"2373","DOI":"10.1016\/S0140-6736(12)60322-5","article-title":"Self-harm and suicide in adolescents","volume":"379","author":"Hawton","year":"2012","journal-title":"Lancet"},{"issue":"4","key":"10.7717\/peerj.9800\/ref-16","doi-asserted-by":"publisher","first-page":"490-495","DOI":"10.1176\/ajp.146.4.490","article-title":"Childhood trauma in borderline personality disorder","volume":"146","author":"Herman","year":"1989","journal-title":"American Journal of Psychiatry"},{"issue":"2","key":"10.7717\/peerj.9800\/ref-17","doi-asserted-by":"publisher","first-page":"176","DOI":"10.3390\/bs5020176","article-title":"Resilience in physically abused children: protective factors for aggression","volume":"5","author":"Holmes","year":"2015","journal-title":"Behavioral Sciences"},{"key":"10.7717\/peerj.9800\/ref-18","doi-asserted-by":"publisher","first-page":"902","DOI":"10.3724\/SP.J.1041.2008.00902","article-title":"Development and psychometric validity of the resilience scale for Chinese adolescents","volume":"40","author":"Hu","year":"2008","journal-title":"Acta Psychological Sinica"},{"key":"10.7717\/peerj.9800\/ref-19","doi-asserted-by":"publisher","first-page":"231","DOI":"10.2147\/PRBM.S75382","article-title":"Resilience in young people living with violence and self-harm: evidence from a Norwegian national youth survey","volume":"8","author":"Huang","year":"2015","journal-title":"Psychology Research and Behavior Management"},{"issue":"12","key":"10.7717\/peerj.9800\/ref-20","doi-asserted-by":"publisher","first-page":"2852","DOI":"10.3390\/ijerph15122852","article-title":"Resilience and poly-victimization among two cohorts of Norwegian youth","volume":"15","author":"Huang","year":"2018","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"10.7717\/peerj.9800\/ref-21","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.chiabu.2016.10.015","article-title":"Emotion dysregulation mediates the relationship between child maltreatment and psychopathology: a structural equation model","volume":"62","author":"Jennissen","year":"2016","journal-title":"Child Abuse and Neglect"},{"issue":"1","key":"10.7717\/peerj.9800\/ref-22","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1177\/1524838010386975","article-title":"The relation between childhood maltreatment and self-injury: a review of the literature on conceptualization and intervention","volume":"12","author":"Lang","year":"2011","journal-title":"Trauma Violence Abuse"},{"issue":"3","key":"10.7717\/peerj.9800\/ref-23","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/s11920-004-0068-y","article-title":"Cognitive-behavioral treatment of borderline personality disorder","volume":"6","author":"Linehan","year":"1993","journal-title":"Current Psychiatry Reports"},{"key":"10.7717\/peerj.9800\/ref-24","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511615788","volume-title":"Resilience and vulnerability: adaptation in the context of childhood adversities","author":"Luthar","year":"2003"},{"key":"10.7717\/peerj.9800\/ref-25","article-title":"Investigation of non-suicidal self-injury and influencing factors among rural middle school students. Yu Y","author":"Ma","year":"2016","journal-title":"Thesis"},{"issue":"2","key":"10.7717\/peerj.9800\/ref-26","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/j.1943-278X.1999.tb01049.x","article-title":"Conceptions of death and suicide in children ages 6\u201312 and their implications for suicide prevention","volume":"29","author":"Mishara","year":"1999","journal-title":"Suicide and Life-threatening Behavior"},{"key":"10.7717\/peerj.9800\/ref-27","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.psychres.04.103","article-title":"What bridges the gap between self-harm and suicidality? The role of forgiveness, resilience and attachment","volume":"241","author":"Nagra","year":"2016","journal-title":"Psychiatry Research"},{"issue":"5","key":"10.7717\/peerj.9800\/ref-28","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1037\/0022-006X.72.5.885","article-title":"A functional approach to the assessment of self-mutilative behavior","volume":"72","author":"Nock","year":"2004","journal-title":"Journal of Consulting and Clinical Psychology"},{"issue":"4","key":"10.7717\/peerj.9800\/ref-29","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1037\/a0014325","article-title":"Deliberate self-harm and alcohol involvement in college-aged females: a controlled comparison in a nonclinical sample","volume":"78","author":"Ogle","year":"2008","journal-title":"The American Journal of Orthopsychiatry"},{"key":"10.7717\/peerj.9800\/ref-30","volume-title":"The revised Olweus bully\/victim questionnaire","author":"Olweus","year":"1996"},{"key":"10.7717\/peerj.9800\/ref-31","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1192\/bjp.181.3.193","article-title":"Fatal and non-fatal repetition of self-harm. Systematic review","volume":"181","author":"Owens","year":"2002","journal-title":"The British Journal of Psychiatry"},{"issue":"10","key":"10.7717\/peerj.9800\/ref-32","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1007\/s00787-019-01287-8","article-title":"Psychopathological mechanisms of early neglect and abuse on suicidal ideation and self-harm in middle childhood","volume":"28","author":"Paul","year":"2019","journal-title":"European Child and Adolescent Psychiatry"},{"key":"10.7717\/peerj.9800\/ref-33","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.chiabu.2017.03.013","article-title":"Emotion dysregulation as a mechanism linking child maltreatment exposure and self-harm behaviors in adolescents","volume":"67","author":"Peh","year":"2017","journal-title":"Child Abuse and Neglect"},{"issue":"2","key":"10.7717\/peerj.9800\/ref-34","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1177\/088626099014002006","article-title":"Adult attachment: a mediator between child sexual abuse and later psychological adjustment","volume":"14","author":"Roche","year":"1999","journal-title":"Journal of Interpersonal Violence"},{"issue":"4","key":"10.7717\/peerj.9800\/ref-35","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1007\/s10964-009-9456-2","article-title":"A multiple mediational test of the relationship between childhood maltreatment and non-suicidal self-injury","volume":"39","author":"Shenk","year":"2010","journal-title":"Journal of Youth and Adolescence"},{"issue":"7-8","key":"10.7717\/peerj.9800\/ref-36","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.chiabu.2012.05.005","article-title":"Child maltreatment, subsequent non-suicidal self-injury and the mediating roles of dissociation, alexithymia and self-blame","volume":"36","author":"Swannell","year":"2012","journal-title":"Child Abuse and Neglect"},{"issue":"5","key":"10.7717\/peerj.9800\/ref-37","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1111\/jcpp.12193","article-title":"Pathways to self-harmful behaviors in young women with and without ADHD: a longitudinal examination of mediating factors","volume":"55","author":"Swanson","year":"2014","journal-title":"Journal of Child Psychology and Psychiatry, and Allied Disciplines"},{"issue":"1","key":"10.7717\/peerj.9800\/ref-38","doi-asserted-by":"publisher","first-page":"1728","DOI":"10.1186\/s12889-019-8075-4","article-title":"Resilience and self-harm among left-behind children in Yunnan, China: a community-based survey","volume":"19","author":"Tian","year":"2019","journal-title":"BMC Public Health"},{"issue":"3","key":"10.7717\/peerj.9800\/ref-39","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1080\/10926771.2017.1338814","article-title":"Emotion dysregulation mediates the relationship between child maltreatment and non-suicidal self-injury","volume":"27","author":"Titelius","year":"2018","journal-title":"Journal of Aggression, Maltreatment and Trauma"},{"issue":"6","key":"10.7717\/peerj.9800\/ref-40","doi-asserted-by":"publisher","first-page":"e0131239","DOI":"10.1371\/journal.pone.0131239","article-title":"Impact of childhood abuse on the risk of non-suicidal self-injury in mainland Chinese adolescents","volume":"10","author":"Wan","year":"2015","journal-title":"PLOS ONE"},{"issue":"3","key":"10.7717\/peerj.9800\/ref-41","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1192\/bjp.2018.263","article-title":"Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents","volume":"214","author":"Wan","year":"2019","journal-title":"The British Journal of Psychiatry"},{"key":"10.7717\/peerj.9800\/ref-42","article-title":"Child maltreatment","author":"World Health Organization","year":"2016"},{"issue":"4","key":"10.7717\/peerj.9800\/ref-43","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1007\/s10802-016-0201-5","article-title":"Prevalence and correlates of direct self-injurious behavior among Chinese adolescents: findings from a multicenter and multistage survey","volume":"45","author":"Xin","year":"2017","journal-title":"Journal of Abnormal Child Psychology"},{"key":"10.7717\/peerj.9800\/ref-44","first-page":"1408","article-title":"The relationship between psychological and resilience, psychopathology and suicidal risks in Chinese college students","volume":"9","author":"Yang","year":"2013","journal-title":"The Chinese Journal of Health Psychology"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/9800.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/9800.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/9800.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/9800.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T07:40:01Z","timestamp":1723534801000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/9800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,8]]},"references-count":44,"alternative-id":["10.7717\/peerj.9800"],"URL":"https:\/\/doi.org\/10.7717\/peerj.9800","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,8]]},"article-number":"e9800"}}