Internet addiction and nonsuicidal self-injury in adolescence: Associations with offline and online social support

Co-developmental trajectories of suicidal ideation and non-suicidal self-injury among Chinese adolescents: Transdiagnostic predictors and association with suicide attempts

INTRODUCTION

Adolescent suicidal ideation (SI) and non-suicidal self-injury (NSSI) are crucial public health issues, yet their co-developmental trajectories during early adolescence and their associations with predictors and outcomes are unclear. This study aimed to (a) identify heterogeneous co-developmental trajectories of SI and NSSI, (b) explore associations between transdiagnostic predictors and trajectories, and (c) assess suicide attempt risk across trajectories.

METHODS

Four hundred fifty-three adolescents (Mage = 12.35 years, 48.3% boys) completed surveys at 6-month intervals across 2 years. At Time 1 (Nov 2020), participants completed surveys encompassing SI, and NSSI, along with family, peer, and individual predictors. Subsequent surveys (Times 2-4) measured SI and NSSI, with suicide attempts queried at Time 4.

RESULTS

Parallel process latent class growth models revealed three co-developmental groups (i.e., Stable low NSSI and SI; Moderate-NSSI and high-SI, parallel decreasing; High-NSSI and moderate-SI, parallel increasing). Multivariate logistic regression indicated that group membership was predicted by parental rejection, parental warmth, bullying victimization, depressive and anxiety symptoms, thwarted belongingness, and perceived burdensomeness. Adolescents in the "High-NSSI and moderate-SI, parallel increasing" group reported the highest suicide attempt frequency.

CONCLUSION

These findings underscore subgroup distinctions and transdiagnostic predictors in comprehending SI and NSSI progression, emphasizing the necessity of dynamic monitoring and tailored interventions for distinct subgroup characteristics.

The role of depressive symptoms and social support in the association of internet addiction with non-suicidal self-injury among adolescents: a cohort study in China

BACKGROUND

Both internet addiction (IA) and non-suicidal self-injury (NSSI) are major public health concerns among adolescents, however, the association between IA and NSSI was not well understood. We aimed to investigate the association between IA and NSSI within a cohort study, and explore the mediated effect of depressive symptoms and the moderating effect of social support in the association.

METHODS

A total of 1530 adolescents aged 11-14 years who completed both the baseline (T1) and 14-month follow-up (T2) survey of the Chinese Adolescent Health Growth Cohort were included for the current analysis. IA, NSSI, depressive symptoms and social support were measured at T1; depressive symptoms and NSSI were measured again at T2. Structural equation models were employed to estimate the mediated effect of depressive symptoms and the moderating effect of social support in the association between IA and NSSI at T2.

RESULTS

IA was independently associated with an increased risk of NSSI at T2, with the total effect of 0.113 (95%CI 0.055-0.174). Depressive symptoms mediated the association between IA and NSSI at T2, and social support moderated the indirect but not the direct effect of IA on NSSI at T2. Sex differences were found on the mediated effect of depressive symptoms and the moderated mediation effect of social support.

CONCLUSIONS

Interventions that target adolescents' NSSI who also struggle with IA may need to focus on reducing depressive symptoms and elevating social support.

Problematic internet use and suicidality and self-injurious behaviors in adolescents: Effects of negative affectivity and social support

BACKGROUND

Problematic internet use (PIU) has been shown to be closely associated with suicidality and self-injurious behavior (SSIB), but the mechanism to help explain this association is understudied. The aim of the present study is to test mediating effects of negative affectivity between PIU and SSIB and whether social support moderates this mediating effect.

METHODS

A sample of 2173 middle and high school students (M_age = 14.66, SD_age = 1.87) in central China were recruited. All participants completed a self-report questionnaire assessing PIU, SSIB, negative affectivity, and social support. Simple mediation analysis and moderated mediation analysis were conducted to examine the roles of negative affectivity and social support in the association between PIU and SSIB.

RESULTS

PIU was positively associated with SSIB, and negative affectivity mediated this association (β = 0.255, Boot 95 % CI: 0.219 to 0.296). The indirect effect of negative affectivity was moderated by social support, with a stronger association between PIU and SSIB for adolescents with lower social support (β = 0.228, Boot 95 % CI: 0.178 to 0.282) than their counterparts (β = 0.098, Boot 95 % CI: 0.068 to 0.133).

LIMITATION

Cross-sectional design with self-report measures.

CONCLUSIONS

PIU is a detrimental risk factor for SSIB, as it is associated with high negative affectivity and increased SSIB, which was more robust for adolescents with lower social support. These results highlight the importance of helping adolescents regulate negative affectivity and improving social support-based preventative interventions to reduce SSIB.

Mediating role of depression in the association between alexithymia and nonsuicidal self-injury in a representative sample of adolescents in Taiwan

BACKGROUND

Nock's (2009) integrated theoretical model suggests that specific intrapersonal vulnerability factors caused by distal risk factors contribute to the development of nonsuicidal self-injury (NSSI). Alexithymia and depression have been found to predict NSSI. Based on Nock's model, alexithymia plays a distal risk factor role to increase the risk of depression-an intrapersonal vulnerability factor-and further increase the risk of NSSI. However, small or unrepresentative samples in past studies limit the generalizability of the results. This study examined the roles of depression and alexithymia in predicting NSSI, as well as the mediating effect of depression in the relation between alexithymia and NSSI in a large representative sample of adolescents in Taiwan.

METHODS

Using a cross-sectional study design, a large representative sample of 2,170 senior high school students in Taiwan was assessed by self-report measures of alexithymia, depression, and NSSI. Mediation analyses were performed to examine whether the relation between alexithymia and NSSI was mediated by depression. The questionnaires were administered in classrooms.

RESULTS

Results showed that alexithymia positively predicted NSSI (β = 0.23, p < .001) and depression can also positively predict NSSI (β = 0.41, p < .001). Additionally, the association between alexithymia and NSSI was fully mediated by depression.

CONCLUSIONS

This study data provided evidence for the mediating role of depression between alexithymia and NSSI, which can be explained by Nock's (2009) integrated theoretical model. The implications of the findings for future research and intervention were discussed.

Factors influencing the addiction characteristics of non-suicidal self-injurious behaviors in adolescents: A case-control study

BACKGROUND

Many studies have shown that in the context of public health emergencies, the incidence rate of adolescent non-suicidal self-injury (NSSI) patients increased dramatically. This paper aims to characterize the behavioral characteristics of adolescent NSSI and analyze the influencing factors of NSSI behavior addiction characteristics.

METHODS

Our research was a case-control study which included 84 adolescents with NSSI (female vs. male: 59 vs. 25) and 84 healthy controls (female vs. male: 53 vs. 31). All the participants enrolled were aged 12-18 years. The differences in the scores of the following five scales were compared between the case and control groups: Egna Minnen Barndoms Uppfostran (EMBU), Perceived Social Support Scale (PSSS), Perceived Stress Scale (PSS); Bergen Social Media Addiction Scale (BSMAS) and Video Game Dependence Scale (VDG-S). The characteristics of NSSI behavior of the study group were evaluated using the Ottawa Self Inventory Chinese Revised Edition (OSIC). And a binary logistic regression model was developed to analyze the factors that influence adolescent NSSI behavioral addiction characteristics.

RESULTS

In the study group, the emotional warmth scores in the father's and mother's rearing style scores in the EMBU were significantly lower than the controls. The BSMAS and VDG-S scores were significantly higher than those in the control group. 38 cases of NSSI with addiction characteristics accounted for 45.24% in the study group. The risk factors for NSSI addiction traits were as follows: female, single-child, high level of VDG-S scores, high scores of excessive interferences in father's rearing style, and high scores of punishments and excessive interferences in mother's rearing style score.

CONCLUSION

Female, only child, internet addiction, and negative parenting styles were predictors of NSSI behavioral addiction characteristics in adolescents. Targeted coping strategies should be developed to reduce the occurrence and development of self-injurious behavior, especially for female adolescents with Internet dependence in one-child families with negative parenting styles.