Using decision tree to predict non-suicidal self-injury among young adults: the role of depression, childhood maltreatment and recent bullying victimization

Importance: Non-suicidal self-injury (NSSI) is a significant mental health issue requiring a deeper understanding of its underlying causes, such as childhood maltreatment, adult bullying victimization, and depression. Previous studies have not adequately addressed the cumulative risks of these factors on NSSI among college students. This population-based study investigates these cumulative risk factors. Design, setting, and participants: The cross-sectional study included 63 university’s college students with a mean age of 19.6 years (N = 95,833). Main outcomes and measures: Two Chi-Square Automatic Interaction Detection (CHAID) decision tree models were used to classify subgroups based on childhood maltreatment and adult bullying victimization experiences and to investigate their cumulative risks of NSSI. Recursive partitioning algorithms determined each predictor variable’s relative importance. Results: The CHAID model accurately predicted NSSI behaviours with an overall accuracy rate of 77.8% for individuals with clinically relevant depressive symptoms and 97.2% for those without. Among depressed individuals, childhood emotional abuse was the strongest NSSI predictor (Chi-Square, 650.747; adjusted P P  Conclusions and relevance: Emotional abuse during childhood profoundly impacts individuals, increasing the risk of NSSI in both depressed and non-depressed individuals. Clinically relevant depressive symptoms have a moderating effect on the relationship between childhood maltreatment, adult bullying victimization, and NSSI. Identifying these factors can inform targeted interventions to prevent NSSI development among young adults. Emotional abuse during childhood has a profound impact on individuals, increasing their risk of non-suicidal self-injury (NSSI), regardless of whether they are depressed or non-depressed.Among depressed individuals, childhood emotional abuse emerges as the strongest predictor of NSSI, followed by sexual and physical abuse.In non-depressed individuals, emotional abuse in childhood assumes a similar role as the strongest NSSI predictor, with sexual abuse and verbal bullying in the past year representing the most significant proximal risks. Emotional abuse during childhood has a profound impact on individuals, increasing their risk of non-suicidal self-injury (NSSI), regardless of whether they are depressed or non-depressed. Among depressed individuals, childhood emotional abuse emerges as the strongest predictor of NSSI, followed by sexual and physical abuse. In non-depressed individuals, emotional abuse in childhood assumes a similar role as the strongest NSSI predictor, with sexual abuse and verbal bullying in the past year representing the most significant proximal risks.</p

Table_1_Bidirectional association between handgrip strength and ADLs disability: a prospective cohort study.docx

BackgroundDecreased handgrip strength (HGS) and activities of daily living (ADL) disability are common in aging populations. No studies have evaluated the bidirectional associations between HGS and ADL disability. This study aimed to explore the bidirectional effects of HGS and ADL disability.MethodsThis study analyzed data from two waves (2011 and 2015) of China Health and Retirement Longitudinal Study (CHARLS). Low HGS is defined by the Asian Working Group for Sarcopenia criteria. Meanwhile, disability was assessed by ADLs scale. The prospective bidirectional association between HGS and ADL disability was examined using binary logistic regression. Subgroup analysis were performed according to age and gender.ResultsA total of 4,902 and 5,243 participants were included in the Stage I and Stage II analyses, respectively. On the one hand, low HGS was significantly associated with subsequent ADL disability. The odds ratio (OR) value of developing BADL disability and IADL disability were 1.60 (95% confidence interval (CI): 1.23–2.08) and 1.40 (95% CI: 1.15–1.70), respectively, in participants with low HGS. On the other hand, baseline ADL disability was associated with an increased risk of developing low HGS. The OR value of developing low HGS were 1.84 (95% CI: 1.34–2.51) and 1.46 (95% CI: 1.19–1.79) for participants with BADL disability and participants with IADL disability, respectively. Lastly, the strength of the bidirectional associations varied among subgroups.ConclusionsA significant bidirectional associations were identified between HGS and ADL disability. Interventions should be developed to prevent the development or progression of both low HGS and ADL disability.</p

Lineweaver-Burk plot for the PL activity at different EGCG analogs concentrations.

<p>The concentration of PL was 2.5 µmol/L. The concentrations of EGCG analogs can be calculated from the [EGCG analogs]/[PL] ratio, which were in the range of 0–0.5 mmol/L. Measurements were done after a 45-min incubation of the mixture of PL and EGCG analogs at 37°C. Experiments were carried out in 100 mmol/L PBS (pH 7.4).</p

Modified Stern-Volmer constant (<i>K</i>_A) and the fraction of fluorophore accessible to the quencher (<i>f</i>_a) for the interactions of EGCG analogs with PL.

<p>Modified Stern-Volmer constant (<i>K</i>_A) and the fraction of fluorophore accessible to the quencher (<i>f</i>_a) for the interactions of EGCG analogs with PL.</p

Effects of incubation time (a) and EGCG analogs concentration (b) on the PL activity.

<p>The concentration of PL was 2.5 µmol/L. The concentrations of EGCG analogs in Figure 2a were 0.50 mmol/L. The concentrations of EGCG analogs in Figure 2b can be calculated from the [EGCG analogs]/[PL] ratio, which were in the range of 0–1 mmol/L. In Figure 2b, the activity was measured after a 45-min incubation of the mixture of PL and EGCG analogs at 37°C. All trials were carried out in 100 mmol/L PBS (pH 7.4) at 37°C.</p

Effects of EGCG analogs concentrations on the transition midpoint temperature (<i>T</i>_m) of PL.

<p>*The concentration of PL was 2.5 µmol/L. The concentrations of EGCG analogs can be calculated from the [EGCG analogs]/[PL] ratio, which were in the range of 0–1 mmol/L. Experiments were carried out in 100 mmol/L PBS (pH 7.4).</p><p>Effects of EGCG analogs concentrations on the transition midpoint temperature (<i>T</i>_m) of PL.</p

The chemical structures of EGCG analogs.

<p>The chemical structures of EGCG analogs.</p

Effects of EGCG analogs on the fluorescence spectra of PL.

<p>a–d: EGCG, GCG, ECG, and EC. The concentration of PL was 2.5 µmol/L. The concentrations of EGCG analogs can be calculated from the [EGCG analogs]/[PL] ratio, which were in the range of 0–1 mmol/L. Measurements were done after a 45-min incubation of the mixture of PL and EGCG analogs at 37°C. Experiments were carried out in 100 mmol/L PBS (pH 7.4).</p

Effects of EGCG analogs on the DSC curve of PL. a–d: EGCG, GCG, ECG, and EC.

<p>The concentration of PL was 2.5 µmol/L. The concentrations of EGCG analogs can be calculated from the [EGCG analogs]/[PL] ratio, which were in the range of 0–1 mmol/L. Measurements were done after a 45-min incubation of the mixture of PL and EGCG analogs at 37°C. Experiments were carried out in 100 mmol/L PBS (pH 7.4).</p

Effect of EGCG analogs concentration on the kinetic parameters of PL (<i>K</i>_m and <i>V</i>_max).

<p>*The concentration of PL was 2.5 µmol/L. The concentrations of EGCG analogs can be calculated from the [EGCG analogs]/[PL] ratio, which were in the range of 0–0.5 mmol/L. Experiments were carried out in 100 mmol/L PBS (pH 7.4) at 37°C.</p><p>Effect of EGCG analogs concentration on the kinetic parameters of PL (<i>K</i>_m and <i>V</i>_max).</p