The mediating role of coping strategy in the association between family functioning and nonsuicidal self-injury among Taiwanese adolescents

Childhood Maltreatment and Non-Suicidal Self-Injury in Adolescents: Testing a Moderated Mediating Model

There is a wealth of evidence to suggest that childhood maltreatment is a major risk factor contributing to non-suicidal self-injury (NSSI) among adolescents. However, how and under what conditions childhood maltreatment is related to NSSI remains largely unclear. This study examined the indirect effect of depressive symptoms in the relation between childhood maltreatment and non-suicidal self-injury, as well as the moderating role of cognitive reappraisal and emotion reactivity in those associations. A sample of 1,984 Chinese adolescents (Mage = 12.84, SD = 1.27, 47.9% girls) completed self-report questionnaires. The results of path analysis showed that childhood maltreatment was significantly related to NSSI and that depressive symptoms play an indirect effect in the relation between them. Cognitive reappraisal mitigated the effect of childhood maltreatment on depressive symptoms, and emotion reactivity strengthened the effect of depressive symptoms on non-suicidal self-injury. The results further showed that the indirect effect of depressive symptoms was more prominent for youths with lower levels of cognitive reappraisal and greater emotion reactivity. Interventions that enhance cognitive reappraisal and reduce emotion reactivity may interrupt the pathway from childhood maltreatment to NSSI via depressive symptoms.

Relationships Between Family Connectedness and Stress-Triggering Problems Among Adolescents: Potential Mediating Role of Coping Strategies

The aim of this study was to provide a better understanding of the mechanisms underlying the relationships between family connectedness, coping strategies, and stress-triggering problems in adolescents. To this end, it longitudinally examined the relationships between these three phenomena in a sample of New Zealand adolescents. Data were the three waves of the Youth Connectedness Project, in which 1,774 adolescents aged 10-17 completed a self-report survey three times at one-year intervals. Using random intercept longitudinal mediation path models, we tested whether and to what extent different coping strategies at T2 functioned as mediators between family connectedness at T1 and stress-triggering problems at T3. As predicted, statistical analyses indicated that family connectedness negatively predicted stress-triggering problems over time, and we found that maladaptive coping, but not adaptive coping, significantly mediated this relationship. This result suggests that family connectedness predicted a reduction in maladaptive coping one year later, and this lower level of maladaptation predicted a reduction in stress-triggering problems a subsequent year later. These and other related findings are important as they highlight several mechanisms shaping unfolding problematic situations experienced by adolescents. Contributions of the results to the existing body of knowledge about adolescents' stress and coping strategies are discussed, as well as their clinical implications for the prevention or reduction of stress experienced by adolescents.

The relationship between loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic: The mediating role of negative emotions and maladaptive coping

INTRODUCTION

Given the observed increased feelings of loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic, further research was needed to determine whether and how the increased loneliness of adolescents during such major public health crisis events affects the risk of problematic smartphone use among adolescents. This study aimed to examine the relationship between loneliness and problematic smartphone use among Chinese adolescents (aged 10-16 years) during the COVID-19 pandemic and to investigate the possible mediating role of negative emotions and maladaptive coping.

METHODS

A total of 672 Chinese adolescents (Mage  = 13.05, SD = 1.51, 50.4% boys, 93.8% from rural areas, 22.5% of whom were only children) took part in this cross-sectional study in April 2022 by completing the Chinese adolescent version of the Loneliness Scale, the Positive and Negative Affect Scale (subscale), the Ways of Coping Questionnaire, and the Mobile Phone Addiction Index Scale.

RESULTS

The serial mediation model revealed that negative emotions and maladaptive coping independently mediated the relationship between adolescents' loneliness and problematic smartphone use. In addition, the mediation effects of "negative emotions-maladaptive coping" could also mediate the relationship between loneliness and problematic smartphone use.

CONCLUSIONS

Loneliness may be positively related to problematic smartphone use through negative emotions and maladaptive coping among adolescents during major public health crisis events, such as the COVID-19 pandemic.

The prevalence of self-injury in adolescence: a systematic review and meta-analysis

In the past 10 years, there has been a growing interest in self-injurious behavior (SIB) among adolescents. The lifetime prevalence of SIB is between 16 and 22% in community sample with females more likely to engage in SIB. There are conflicting results about the global distribution of the prevalence of SIB and whether the SIB has increased in the 21st century. Our aim in the current study was to conduct a systematic search of and meta-analysis on the prevalence of SIB in adolescents over the past 5 years' worth of published papers and to examine gender, continental, and year differences. We conducted a systematic search in June 2020 of six databases (PubMed, Scopus, Web of Science, OVID Medline, PsycINFO, EBSCO) with three main search terms: "self-injurious behavior," "prevalence," and "adolescence." Article inclusion criteria were (a) written in English; (b) published between January 1, 2015, and June 18, 2020; and (c) focused on a community sample. Titles and abstracts of the articles were screened first. Then, the relevant full texts were read, and those that met the inclusion criteria were collected. We used Comprehensive Meta-Analysis software was used to conduct the analyses. After the screening process 97, articles were included in the meta-analysis. The age of the samples ranged from 11.00 to 18.53 years. The overall average prevalence of nonsuicidal self-injury in the studies was 16%. There was a significant gender difference: females reported a higher prevalence than males (19.4% and 12.9%, respectively). A significantly higher prevalence was found among Asian articles than those from other continents (19.5% and 14.7%, respectively). The prevalence of SIB did not change significantly between 2013 and 2018. The current research draws attention to the high prevalence of SIB among adolescents, especially among females and those living in Asia. It is important to address this behavior, both in terms of prevention and intervention.

Impact of the COVID-19 and psychological risk factors on non-suicidal self-injury behavior among high school students: a one-year follow-up study

OBJECTIVES

Non-suicidal self-injury (NSSI) behavior is a severe public health issue in adolescents. This study investigated the possible impact of the coronavirus disease 2019 (COVID-19) and analyzed psychological risk factors on adolescent NSSI.

METHODS

A one-year follow-up study was conducted in September 2019 (Time 1) and September 2020 (Time 2) among 3588 high school students. The completed follow-up participants (N = 2527) were classified into no NSSI (negative at both time points), emerging NSSI (negative at Time 1 but positive at Time 2), and sustained NSSI (positive at both time points) subgroups according to their NSSI behaviors before and during the COVID-19 pandemic. Perceived family functioning, perceived school climate, negative life events, personality traits (neuroticism, impulsivity, and self-control) were assessed using self-report scales.

RESULTS

The data indicated an increase (10.3%) in the incidence of NSSI. Compared to no NSSI subjects, the emerging NSSI and sustained NSSI subgroups had lower perceived family functioning, higher neuroticism, higher impulse-system but lower self-control scores, and more negative life events. Logistic regressions revealed that after controlling for demographics, neuroticism and impulse-system levels at Time 1 positively predicted emerging NSSI behavior, and similarly, higher neuroticism and impulsivity and lower self-control at Time 1 predicted sustained NSSI behavior.

CONCLUSIONS

These findings highlighted the aggravated impact of the COVID-19 on NSSI, and suggested that individual neuroticism, impulsivity, and self-control traits might be crucial for the development of NSSI behavior among adolescent students.

A systematic review and meta-analysis of factors related to non-suicidal self-injury among Chinese adolescents

BACKGROUND

Over the past several decades the prevalence of adolescent non-suicidal self-injury (NSSI) has been rising steadily. Understanding the factors associated with NSSI is a critical public health concern. The current study aims to explore the critical factors related to NSSI among Chinese adolescents.

METHODS

A systematic literature search was conducted to identify the studies meeting our eligibility criteria (published until June 2022) in PubMed, Web of Science, Science Direct, Springer Link, CNKI, VIP, and Wanfang data. The meta-package of R language was used to perform a meta-analysis to compute the pooled effect (r).

RESULTS

A total of 59 studies were included in this analysis, with a sample size of 192,546. Twenty-four democratic, personal, and social factors were examined in current study. The pooled effect value (r) has revealed that 23 factors are associated with NSSI behaviors among Chinese adolescents. The factor, Internet addiction, has demonstrated the greatest association with NSSI compared to other factors.

CONCLUSION

Consistent with previous studies on adolescent NSSI, findings have demonstrated that a number of demographic, personal, and social factors significantly contribute to NSSI behaviors among Chinese adolescents. Future research on prevention and intervention for adolescent NSSI may benefit from targeting these factors.

Association between life events, anxiety, depression and non-suicidal self-injury behavior in Chinese psychiatric adolescent inpatients: a cross-sectional study

Background

Non-suicidal self-injury (NSSI) is a major public health concern among adolescents. Further research is needed into contributors to this behavior, in particular among adolescents with psychiatric disorders. The aim of the present study was to explore the impact of life events and emotional stress on NSSI among hospitalized psychiatric adolescents.

Methods

In this cross-sectional study, 505 Chinese psychiatric adolescent inpatients 10-19  years old completed questionnaires about sociodemographic characteristics and NSSI as well as the Adolescent Self-Rating Life Events Checklist (ASLEC), the State-Trait Anxiety Inventory Form Y, and the Center for Epidemiological Studies Depression Scale. Chi-square test was used to compare the incidence of NSSI in psychiatric adolescent patients with different sociodemographic. T-test was used to compare the total scores and dimension scores of the ASLEC, STAI-Y, and CES-D between the NSSI group and the non-NSSI group. A binary logistic regression model was built to explore the relationships among sociodemographic characteristics, questionnaire scores and NSSI.

Results

Most psychiatric adolescent inpatients (393, 77.8%) reported NSSI behavior. The higher risk for NSSI was observed among female (odds ratio [OR] 2.665, 95% confidence interval [CI] 1.575-4.510), younger adolescents (10-14 years; OR 2.021, 95% CI 1.258-3.245), with a suicide history (OR 2.479, 95% CI 1.549-3.967), or with depression symptom (OR 3.217, 95% CI 1.572-6.582) and those with higher scores of ASLEC (OR 1.019, 95% CI 1.010-1.029).

Conclusion

Our study in China is one of the first to apply to adolescent inpatients the diagnostic criteria of NSSI in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders. Our analysis suggests that NSSI prevalence is disturbingly high among adolescents with mental illness in China. A better understanding of contributing factors, especially negative life events and negative emotions, may guide interventions that can reduce its prevalence.

Cyberbullying Victimization and Nonsuicidal Self-Injury in Early Adolescents: A Moderated Mediation Model of Social Anxiety and Emotion Reactivity

This study examined the mediating role of social anxiety in the relation between cyberbullying victimization and nonsuicidal self-injury (NSSI), as well as the moderating role of emotion reactivity in those associations. Participants included 2,864 adolescents (M_age = 12.46, SD = 1.36, 47.1 percent girls). Results of path analysis showed that cyberbullying victimization was significantly related to NSSI, and social anxiety plays a mediating role in the relation between them. Emotion reactivity strengthened the effect of cyberbullying victimization on NSSI and of social anxiety on NSSI. The results further showed that the mediating effect of social anxiety was more prominent for youths who have higher levels of emotion reactivity. Interventions to reduce adolescent social anxiety and emotion reactivity may interrupt the pathway from cyberbullying victimization to NSSI.

Associations Between Family Function and Non-suicidal Self-injury Among Chinese Urban Adolescents with and Without Parental Migration

The study aims to explore the effect of family function on non-suicidal self-injury (NSSI) among Chinese urban adolescents with and without parental migration. Between April 21st to May 12th, 2021, adolescents were recruited from Shenzhen city of Guangdong province, China (n = 124,357). Of all the participants, 22,855 (18.4%) were left-behind children (LBC). Family function, NSSI, depression, and socio-demographic characteristics were assessed using a series of self-reported questionnaires. Urban LBC had a higher NSSI frequency, while a lower level of family function than non-LBC. After controlling for confounders, parental migration was significantly associated with NSSI, and family dysfunction was a robust risk factor for NSSI as well. The protective effect of family function on NSSI of LBC was stronger than non-LBC. This implies that children with higher levels of family function tend to exhibit a lower frequency of NSSI, especially in those with parental migration. In practice, adolescents' NSSI prevention and intervention strategies should focus on improving family function.

An investigation of self-injury in female adolescents: a qualitative study

This study aimed to investigate the phenomenon of self-injury among female adolescents. The research was qualitative, and the sampling method was purposive non-random; the sample size was 20 Iranian girl adolescents aged 13-15 years who had experienced non-suicidal self-injury. Data were collected through semi-structured interviews. The data analysis process was performed during three coding steps (open, axial, selective), through which the basic codes and categories were identified. Study results indicate that the main factors in adolescents' self-injury were individual or psychological (thoughts, emotions, and behaviors) and social (peers, family, communication with different gender, communication with others, media/cyberspace, school, and economic). In the former, the role of emotions was remarkable, while in the latter, the family played a key role. Further, results revealed that communication within the family was an important motivating and sustentative factor in adolescents' self-injury. The results can help counselors in working with adolescents who self-injure; results can also be used in the development and implementation of treatment plans.

Children's and Adolescents' Happiness and Family Functioning: A Systematic Literature Review

BACKGROUND

the present research represents the first systematic review of the literature on the relation between happiness (i.e., subjective well-being, life satisfaction, positive affect) and family functioning in families with children aged 6-18 years.

METHOD

relevant articles were systematically searched in three scientific databases (i.e., PsycInfo, Pubmed, and Web of Science) in June 2022. The databases were searched for original articles published after 1968 with the keywords "happiness" and "family functioning."

RESULTS

of the 2683 records recovered, 124 original articles met the eligibility criteria and were included in the review. The articles were divided according to four emergent themes: (1) family dimensions and happiness; (2) global family functioning (i.e., family functioning, and family relationships), environmental variables, and happiness; (3) parental differences; (4) longitudinal studies.

CONCLUSIONS

the results of the review provide evidence for a positive relation between happiness and family functioning, across different cultures and age groups: Family dimensions (e.g., cohesion, communication) were found to strongly predict children's and adolescents' happiness. Future studies should investigate the differences between fathers and mothers using multi-informant and mixed methods procedures and a longitudinal research approach. The implications of the findings for children's positive development are discussed.

Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis

Background

Adolescents with immature mind and unstable emotional control are high-risk groups of non-suicidal self-injury (NSSI) behavior. We meta-analyzed the global prevalence of NSSI and prevalence of NSSI characteristics in a non-clinical sample of adolescents between 2010 and 2021.

Methods

A systematic search for relevant articles published from January 1, 2010 to June 30, 2021 was performed within the scholarly database search engines of CBM, CNKI, VIP, Wanfang, PubMed, Web of Science, PsycINFO, and Embase. Eligibility criteria were as follows: provided cross-sectional data on the prevalence of NSSI; the subjects were non-clinical sample adolescents; and a clear definition of NSSI was reported. We used the following definiton of NSSI as our standard: the deliberate, self-inflicted destruction of body tissue, such as cutting, burning, and biting, without attempted suicide. The quality evaluation tool for cross-sectional studies recommended by the JBI was used. The global prevalence of NSSI was calculated based on the random-effects model by Comprehensive Meta-analysis version 3.0. Subgroup analyses were performed to compare the prevalence according to sex, living place, smoking or drinking history, and family structure.

Results

Sixty-two studies involving 264,638 adolescents were included. The aggregate prevalence of NSSI among a non-clinical sample of adolescents was similar between over a lifetime (22.0%, 95% CI 17.9-26.6) and during a 12-month period (23.2%, 95% CI 20.2-26.5). Repetitive NSSI was more common than episodic NSSI (20.3% vs. 8.3%) but the frequency of mild injury (12.6%) was similar to that of moderate injury (11.6%). Multiple-method NSSI occurred slightly more often compared than one-method NSSI (16.0% vs. 11.1%). The top three types of NSSI in adolescents were banging/hitting (12.0%, 95% CI 8.9-15.9), pinching (10.0%, 95% CI 6.7-14.8), and pulling hair (9.8%, 95% CI 8.3-11.5), and the least common type was swallowing drugs/toxic substances/chemicals (1.0%, 95% CI 0.5-2.2). Subgroup analyses showed that being female, smoking, drinking, having siblings, and belonging to a single-parent family may be linked to higher prevalence of NSSI.

Conclusion

This meta-analysis found a high prevalence of NSSI in non-clinical sample of adolescents, but there are some changes in severity, methods, and reasons. Based on the current evidence, adolescents in modern society are more inclined to implement NSSI behavior by a variety of ways, which usually are repetitive, and moderate and severe injuries are gradually increasing. It is also worth noting that adolescents with siblings or in single-parent families are relatively more likely to implement NSSI behavior due to maladjustment to the new family model. Future research needs to continue to elucidate the features and risk factors of NSSI so as to intervene in a targeted way.

Limitation

The limitation of this study is that the heterogeneity among the included studies is not low, and it is mainly related to Chinese and English studies. The results of this study should be used with caution.

Systematic review registration

[www.crd.york.ac.uk/prospero/], identifier [CRD42022283217].

Stressful life events and non-suicidal self-injury among Chinese adolescents: A moderated mediation model of depression and resilience

Stressful life events are associated with an increased risk of non-suicidal self-injury (NSSI) in adolescence, but the mechanisms explaining this association are unclear. Based on the experiential avoidance model of NSSI, and the protective factor model of resilience, the current study tested depression as a mediator and resilience as a moderator of this association. Chinese adolescents (N = 643; M_age = 15.91; 52.10 % female), anonymously completed self-report measures in classrooms. Results showed that stressful life events was linked to adolescent NSSI in part because of adolescent depression, and resilience was a protective factor that buffered this effect. These findings can inspire practitioners to pay attention to the interaction of risk factors and protective factors when providing prevention and intervention for adolescent NSSI.

The relationship between family functioning and non-suicidal self-injury in adolescents: A structural equation modeling analysis

BACKGROUND

Previous research has suggested that depressive symptoms, emotional competence, and posttraumatic stress symptoms (PTSS) may mediate the association between family functioning and non-suicidal self-injury (NSSI). Therefore, this study aimed to evaluate the mediation effects of depressive symptoms, emotional competence, and COVID-related PTSS on the relationship between family functioning and NSSI in adolescents.

METHOD

A sample of 5854 adolescents was recruited from June 16 to July 8, 2020. The data for family functioning, depressive symptoms, emotional competence, COVID-related PTSS, and NSSI behavior of adolescents were collected via self-reported questionnaires. A structural equation model was constructed to examine the relationship, and a bootstrap analysis was conducted to evaluate the mediation effects.

RESULTS

The reporting rate of adolescent NSSI was 30.2%. The poor family functioning was positively associated with adolescent NSSI (β = 0.130, 95% CI = 0.093-0.182), which was mediated by depression with effect size of 0.231 (95% CI = 0.201-0.257). The pathway coefficients between emotional competence and NSSI, and depression, COVID-related PTSS and NSSI, though statistically significant were unlikely to be clinically meaning with values of 0.057 and 0.015. There was no mediating effect by COVID-related PTSS. The pathways initially constructed between family functioning and COVID-related PTSS, emotional capacity and COVID-related PTSS were not been verified.

LIMITATIONS

It was unclear whether this mediational effect would be supported in a longitudinal design. The application and extension of this model toward other regions and countries, and different ages need to be further explored.

CONCLUSION

The interventions of adolescent NSSI should focus on both the family level and individual levels. Improving family environment, screening depressive symptoms, enhancing emotional competence and lessening COVID-related PTSS may reduce NSSI.

Depressive symptoms mediate the association between maternal authoritarian parenting and non-suicidal self-injury among Chinese adolescents

BACKGROUND

Non-suicidal self-injury (NSSI) is a significant public health concern. Authoritarian parenting is a common parenting style in China. Authoritarian parenting is associated with NSSI in adolescents. Little is known about the mechanism underlying this association. This study was to investigate the mediating effect of depressive symptoms on the association between maternal authoritarian parenting and NSSI among Chinese adolescents.

METHODS

A total of 7072 adolescents who participated in the 1-year follow-up of Shandong Adolescent Behavior & Health Cohort (SABHC) were included for the analysis. A self-administered questionnaire was used to assess authoritarian parenting, depressive symptoms, non-suicidal self-injury, and family demographics in November-December in 2015. One year later, a follow-up survey was carried out to assess participants' depressive symptoms and NSSI.

RESULTS

Of the sample, mean age was 14.58 (SD = 1.46) and 3536 (50%) were female at baseline. 19.4% adolescents reported having ever NSSI over the past 12 months at baseline, and 8.8% reported having ever NSSI at 1-year follow-up. The association of maternal authoritarian parenting with subsequent NSSI was at least partially mediated by depressive symptoms. Mediation analyses showed that effect size was 0.194 in the entire sample, 0.192 in females and 0.193 in males, respectively.

LIMITATION

All variables were measured based on self-report.

CONCLUSIONS

Maternal authoritarian parenting style is a significant predictor of NSSI and its association with NSSI is partially mediated by depressive symptoms among Chinese adolescents. It may be important to intervene poor parenting styles and depression to reduce the risk of NSSI in Chinese adolescents.

Cyberbullying victimization and nonsuicidal self-injury in adolescents: Testing a moderated mediating model of emotion reactivity and dispositional mindfulness

BACKGROUND

Little is known about how cyberbullying victimization may influence adolescent nonsuicidal self-injury (NSSI) and what conditions may buffer the detrimental effects of cyberbullying victimization. By integrating multiple theories, this study investigated emotion reactivity as an underlying mediator and mindfulness as a potential moderator to explain the link between cyberbullying victimization and NSSI among Chinese adolescents.

METHOD

A total of 2,523 participants with an age range of 11 to 16 years old (Mage = 13.22, SD = 1.60, 48.4% girls) completed assessments.

RESULTS

After controlling SES, age, gender, traditional bullying victimization, and child maltreatment, latent moderated structural equation modeling revealed that emotion reactivity mediated the association between cyberbullying victimization and NSSI. In addition, dispositional mindfulness was found to buffer the relation between cyberbullying victimization and NSSI, but not the relation between cyberbullying victimization and emotion reactivity.

LIMITATIONS

This study was cross-sectional in nature and relied exclusively upon self-report measures.

CONCLUSIONS

The findings provide researchers and practitioners with a deeper understanding of the relation between cyberbullying victimization and NSSI among adolescents and its underlying mechanism. Suggested intervention and prevention strategies include helping youth reduce emotion reactivity to break the cyberbullying victimization to NSSI cycle and to enhance youths' mindfulness to buffer against the ill effects of cyberbullying victimization.

Prevalence and psychosocial risk factors of nonsuicidal self-injury among adolescents during the COVID-19 outbreak

The research investigated the prevalence of nonsuicidal self-injury (NSSI) during the COVID-19 outbreak and identified the psychosocial risk factors among junior high school students in Taiwan. Cross-sectional design was applied and 1,060 participants (Mage = 14.66, SD = 0.86 years) were recruited into the study. The prevalence of NSSI was found to be 40.9% (95% confidence interval, 37.9%-43.9%) during the COVID-19 outbreak. The results suggested that the self-injurers group were mostly female, and scored significantly higher in neuroticism, depression, impulsivity, alexithymia, virtual social support, dissatisfaction with academic performance, and lower in subjective wellbeing, self-esteem, actual social support, and family function than the non-injurers group. In addition, high neuroticism, low self-esteem, high virtual social support, high impulsivity, and high alexithymia were independently predictive in the logistic regression analysis. The principal results of this study suggested that NSSI was extremely prevalent among adolescents during the COVID-19 outbreak, and in particularly, personality and virtual environment risk factors and enhancing self-esteem should be the focus of NSSI preventive strategies when targeting this age population. Our results provide a reference towards designing NSSI prevention programs geared toward the high school population during the COVID-19 pandemic.

The Role of Psychological Factors in Non-suicidal Self-injury of Female Adolescents

Background: Non-suicidal self-injury (NSSI) is defined as inflicting damage to one’s own body. It begins in adolescence and tends to become chronic. Objectives: Considering the high prevalence and chronicity of NSSI among girls, the present study aimed to investigate the factors affecting the prevalence of NSSI in female adolescents from their perspective. Methods: The participants consisted of 604 female high-school students in Saveh, aged 14 - 17 years (14.29 ± 1.11), who were selected via random cluster sampling from November 2018 to January 2019. They answered six questionnaires, including the Inventory of Statements About Self-injury (ISAS), Ways of Coping questionnaire (WCQ), Child Abuse Self-report scale (CASRS), Family Emotional Involvement and Criticism scale (FEICS), Emotion Reactivity scale (ERS), and Aggression questionnaire (AQ). Data were analyzed using logistic regression analysis. Results: The predictor variables of child abuse, emotion reactivity, perceived parental criticism, family emotional involvement, and problem- and emotion-focused coping styles could successfully distinguish NSSI individuals from those without NSSI (P < 0.05). There were no significant differences between minor and moderate groups. Conclusions: Family emotional support is a protective factor, while criticism, child abuse, and emotion-focused coping style are risk factors for NSSI.

Bullying Experiences and Nonsuicidal Self-injury among Chinese Adolescents: A Longitudinal Moderated Mediation Model

Bullying experiences play an important role in non-suicidal self-injury (NSSI). However, little is known about how and in what conditions different bullying experiences (i.e., experiences of being pure bullies, pure victims, and bully-victims) may influence NSSI. Guided by the transactional model of development and the integrated model of NSSI, the current study investigated two potential mediators (i.e., peer acceptance and depressive symptoms) and one potential moderator (i.e., psychological resilience) of the relations between different bullying experiences and NSSI. Participants were 812 Chinese adolescents (43% female; Mage at Wave 1 = 13.15 years) from a two-wave longitudinal study with data spanning 1 year. The results show that all three types of bullying experiences can relate to a higher likelihood of NSSI through two indirect pathways: (a) lower peer acceptance to more depressive symptoms, or (b) more depressive symptoms. These indirect effects were weaker for adolescents with higher (versus lower) levels of psychological resilience. Moreover, when bully-victims were distinguished from pure bullies and pure victims and the unique effects for all three groups were tested, the direct and indirect effects were most evident among bully-victims. These findings imply that it is necessary to distinguish bully-victims from pure bullies and pure victims. The results indicate that NSSI may be effectively reduced if interventions focus on promoting peer acceptance and reducing adolescent depressive symptoms, particularly for bully-victims with lower levels of psychological resilience.

Family functioning, coping strategy, and suicidal ideation among adolescents

Background and aim: Adolescent suicide has become a central issue around the world, including in Malaysia, which needs attention. The current study investigated the mediating effect of coping strategy in the association between family functioning and suicidal ideation among adolescents in Kuala Lumpur, Malaysia. Method: A total of 852 school-attending adolescents aged 13-17 years were recruited by multistage cluster sampling. The relationships between all the study variables were analysed using Pearson's correlation. Moreover, the mediation model was tested using SPSS PROCESS macro, while sex differences in suicidal ideation were examined using independent samples t-test. Results: Results showed that family cohesion, family flexibility, and problem-focused coping negatively correlated with adolescents' suicidal ideation. Problem-focused coping also mediated the association between family flexibility and suicidal ideation. There was a significant difference in suicidal ideation for males and females. Conclusion: Family functioning and coping strategy are related to adolescents' suicidal ideation, while problem-focused coping plays a crucial role in the relationship between family flexibility and suicidal ideation.

Prevalence of Internet Addiction during the COVID-19 Outbreak and Its Risk Factors among Junior High School Students in Taiwan

The coronavirus disease 2019 (COVID-19) outbreak has significantly disrupted normal activities globally. During this epidemic, people around the world were expected to encounter several mental health challenges. In particular, Internet addiction may become a serious issue among teens. Consequently, this study aimed to examine the prevalence of Internet addiction and identify the psychosocial risk factors during the COVID-19 outbreak. This study was constructed using a cross-sectional design with 1060 participants recruited from among junior high school students around Taiwan using stratified and cluster sampling methods. Taiwan's first COVID-19 case was diagnosed on 28 January 2020. New cases exploded rapidly in February, and as a result, participants were surveyed during March 2 through 27 March 2020. The prevalence of Internet addiction was found to be 24.4% during this period. High impulsivity, high virtual social support, older in age, low subjective well-being, low family function, and high alexithymia was all independently predictive in the forward logistic regression analyses. The prevalence rate of Internet addiction was high among junior high school students during the COVID-19 outbreak. Results from this study can be used to help mental health organizations and educational agencies design programs that will help prevent Internet addiction in adolescents during the COVID-19 pandemic.

When language is maladaptive: recommendations for discussing self-injury

Purpose

The purpose of this paper is to call on researchers and clinicians to carefully consider the terminology used when discussing non-suicidal self-injury (NSSI), and specifically the use of the term “maladaptive” coping.

Design/methodology/approach

Drawing on literature regarding stigma, language and self-injury to support the argument that the term maladaptive is inappropriate to describe self-injury.

Findings

Use of the term maladaptive conflates short-term effectiveness with long-term outcomes and ignores context in which the behaviour occurs.

Social implications

Use of the term maladaptive to describe self-injury can invalidate the person with a history of NSSI, impacting stigma and potentially help-seeking. An alternate framing focussed on specific coping strategies is offered.

Originality/value

Language is a powerful medium of communication that has significant influence in how society shapes ideas around mental health. In proposing a change in the way the authors’ talk about self-injury there is potential to significantly improve the wellbeing of people with lived experience of self-injury.

Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset

BACKGROUND

Adolescence is characterized by developmental changes in social relationships, which may contribute to, or protect against, psychopathology and risky behaviors. Non-suicidal self-injury (NSSI) is one type of risky behavior that typically begins during adolescence and is associated with problems in relationships with family members and peers. Prior research on social factors in adolescent NSSI has been limited, however, by a narrow focus on specific interpersonal domains, cross-sectional methods, retrospective self-report of childhood experiences, and a failure to predict NSSI onset among as-yet-unaffected youth.

METHODS

We investigated these relationships in 2127 urban-living adolescent girls with no NSSI history at age 13, who were participating in a longitudinal cohort study (Pittsburgh Girls Study). We used discrete-time survival analyses to examine the contribution of time-varying interpersonal risk factors, assessed yearly at ages 13-16, to NSSI onset assessed in the following year (ages 14-17), controlling for relevant covariates, such as depression and race. We considered both behavioral indicators (parental discipline, positive parenting, parental monitoring, peer victimization), and cognitive/affective indicators (quality of attachment to parent, perceptions of peers, and perceptions of one's own social competence and worth in relation to peers) of interpersonal difficulties.

RESULTS

Parental harsh punishment, low parental monitoring, and poor quality of attachment to parent predicted increased odds of subsequent adolescent NSSI onset, whereas positive parenting behaviors reduced the odds of next year NSSI onset. Youth who reported more frequent peer victimization, poorer social self-worth and self-competence, and more negative perceptions of peers were also at increased risk of NSSI onset in the following year. When tested simultaneously, no single parenting variable showed a unique association with later NSSI onset; in contrast, peer victimization and poor social self-worth each predicted increased odds of later NSSI onset in an omnibus model of peer and parent relationship characteristics.

CONCLUSIONS

In this urban sample of adolescent girls, both peer and parent factors predicted new onset NSSI, although only peer factors were associated with subsequent NSSI in combined multivariate models. Results further suggest that both behavioral and cognitive/affective indicators of interpersonal problems predict NSSI onset. These findings highlight the relevance of family and peer relationships to NSSI onset, with implications for prevention of NSSI onset among at-risk youth.