Non-suicidal self-injury in the COVID-19 pandemic: results from cross-sectional surveys among Brazilian adults from 2020 to 2023

The multilevel psychosocial stressors associated with COVID-19 pandemic set the stage to investigate risk factors and groups susceptible for non-suicidal self-injury (NSSI). A national sample of 9,929 Brazilian adults aged 36.1 years on average participated in the study. Cross-sectional data were collected in 2020, 2021, 2022, and 2023. NSSI levels were considered high in the total sample (13.2%) when compared to other studies in this context. The variables with the highest explanatory power in the regression models were age, anxiety, and depression. The main risk factors were being younger, living in the South or Southeast regions of Brazil, having lower educational attainment, and having higher rates of anxiety and depression. Respondents had the highest probability of NSSI in 2022. The sustained higher rates of NSSI in 2023 compared to the beginning of the pandemic underscores the need for continuous monitoring and the development of preventive actions for self-injurious behaviors.

Exploring the effect of environmental sensitivity on emotional fluctuations among adolescents during the COVID-19 pandemic: a three-wave longitudinal study

Introduction

The COVID-19 pandemic significantly impacted the emotional well-being of adolescents worldwide. Some studies suggested that individuals with high Environmental Sensitivity may have been more likely to experience poor psychological adjustment during the pandemic than those with lower sensitivity. However, there is still limited research on how emotional responses varied across different stages of the pandemic and whether Environmental Sensitivity increased adolescents' vulnerability to the psychological impact of prolonged pandemic restrictions.

Methods

To address this gap, this study used a three-year longitudinal design (2020-2022) with a sample of 453 adolescents. They completed an online survey measuring their positive and negative emotions throughout the pandemic period, with Environmental Sensitivity considered a time-invariant covariate.

Results

The results revealed that all participants, regardless of their level of Environmental Sensitivity, experienced a decrease in positive emotionality between the first and second years. However, this trend reversed, showing an increase between the second and third years. Regarding negative emotions, highly sensitive adolescents experienced a significant linear increase over time. In contrast, low-and medium-sensitive adolescents exhibited a quadratic trend, with a notable increase in negative emotions between the first and second years, followed by a slight decrease between the second and third years.

Discussion

These findings provide further evidence of the negative impact of the pandemic on adolescents' emotional well-being. They also support the notion that Environmental Sensitivity is associated with individuals' ability to respond and adjust to adverse life events, with significant implications for future research and practice.

COVID-19 factors and self-injurious behaviors among US college students: findings from the healthy minds study 2020

BACKGROUND

The COVID-19 pandemic has dramatically altered the way of life in the United States, which may be linked to self-injurious behaviors.

METHODS

We conducted a secondary analysis of data from the Fall 2020 Cohort of the Healthy Minds Survey, a non-probability sample of students enrolled at one of 28 universities across the United States. Participants completed an online survey during the COVID-19 pandemic (September-December, 2020).

RESULTS

Nearly a quarter of the sample (n = 6999) reported engaging in non-suicidal self-injury (NSSI), 12.41% (n = 3819) reported suicidal ideation, 4.98% (n = 1531) reported making a suicide plan, and 1.09% (n = 334) reported a suicide attempt over the past 12 months. When accounting for all COVID-19 factors in the same model, COVID-19 related concern, COVID-19 related discrimination, financial distress, and infection were significantly associated with NSSI, suicidal ideation, and suicide plan; caregiving was significantly associated with lower odds of engaging in non-suicidal self-injury. None of the factors were associated with suicide attempt.

CONCLUSIONS

This study showed that various COVID-19 factors were related to SIB. Interventions may consider multiple dimensions of COVID-19 and their specific impacts.

The impact of perceived life stress and online social support on university students' mental health during the post-COVID era in Northwestern China: gender-specific analysis

BACKGROUND

Before the pandemic, research had already established the potential impact of perceived life stress and social support on the mental health status of Chinese students. However, in the Post-COVID Era, the specific mechanisms linking these variables and the distinct role of online social support remain relatively unexplored.

METHODS

After the cessation of China's dynamic zeroing policy, a total of 1180 university students from Northwestern China participated in this study by completing a demographic questionnaire, as well as self-report measures assessing mental health, perceived life stress, and online social support.

RESULTS

Approximately 25% of students exhibited psychological symptoms. When examining different categories of perceived life stress, males reported experiencing a significantly greater impact in terms of punishment and interpersonal relationships compared to females. Females experienced significantly higher levels of learning pressure compared to males. Specific types of perceived life stress were found to be significant predictors of students' mental health status. Moreover, online social support was identified as a significant moderator in the relationship between all types of perceived life stress and mental health, irrespective of gender.

CONCLUSION

Our study findings unveiled two significant aspects: Firstly, the impact of perceived life stress on the mental health of students was identified as a risk factor. Secondly, the role of online social support emerged as a protective factor, particularly in the post-pandemic context. Additionally, gender-specific patterns were observed in these relationships.

Covid-19 Lockdown and Non-Suicidal Self-Injury: A Mixed Methods Analysis of NSSI During Australia's National Lockdown

OBJECTIVE

The Covid-19 global pandemic has meant large parts of the world's population have been isolated from others for often months at a time due to lockdown measures to stop the spread. The effects of isolation can be damaging and increase risk of self-injury (NSSI) and suicide. We examined the effects of the first Australian national lockdown on NSSI urges and behavior.

METHOD

We asked 345 people with current or past lived experience of NSSI both quantitative and qualitative questions about how their urges and behavior changed during lockdown and assessed how changes were related to demographic variables including work and living conditions.

RESULTS

Women, socially disadvantaged and unemployed people were at greater risk of increased NSSI urges and behavior. Social connection was important, with both quantitative and qualitative responses indicating that for some, decreased social anxiety and social pressures was related to a reduction in NSSI, whereas for others the lack of social connection and engagement was associated with worsening urges and behaviors.

CONCLUSION

Lockdown had mixed impacts on people with lived experience of NSSI, with most reporting no change or a decrease to urges and behavior, however, for socially disadvantaged people in particular, lockdown lead to worsening urges and behavior and even relapse. Future research might examine these effects longitudinally and with greater focus on intersectionality.HighlightsIdentified NSSI risk/protective factors, and an understanding of lived experienceLockdowns have mixed impacts, some people decreased, some increased NSSISocial connection plays an important role in NSSI engagement and reduction.

The pooled prevalence and influential factors of non-suicidal self-injury in non-clinical samples during the COVID-19 outbreak: A meta-analysis

BACKGROUND

COVID-19 has had an enormous impact on the mental health of people around the world, particularly adolescents. Non-suicidal self-injury (NSSI) is one of the most prominent and dangerous behaviors associated with suicide. However, few meta-analyses of the NSSI prevalence have ever been conducted since the COVID-19 outbreak. Here, we conducted a meta-analysis to estimate the pooled prevalence and elucidate the influencing factors for NSSI.

METHODS

We searched PubMed, Web of Science, Embase, APA PsycINFO, CNKI and Wanfang Database for relevant literature published before April 2022. Pooled prevalence and 95 % confidence interval (CI) were used to assess NSSI prevalence. Subgroup and meta-regression analyses were performed to clarify the potential influencing factors.

RESULTS

A total of 15 studies with 24,055 participants were eventually included. The results showed that the pooled overall prevalence of NSSI among overall samples during the COVID-19 pandemic was 22.5 % (95 % CI: 17.2 % to 28.9 %). Subgroup and meta-regression analyses revealed that the crucial influencing factors for NSSI included gender, age, regional distribution, and suicidal ideation. Specifically, the NSSI prevalence among adolescents and adults during the pandemic was 32.40 % and 15.70 %, respectively. Most importantly, gender is a significant influencing factor for NSSI among adolescents.

CONCLUSIONS

The pooled prevalence of NSSI during the COVID-19 outbreak has surged to alarming heights, especially among adolescents. The prevalence of NSSI may be influenced by complex factors such as gender and age. Therefore, it is critical to pay attention to NSSI behaviors in the adolescent population, particularly male adolescents who appear to be susceptible.

A Comparison Between Before and During the Pandemic in Nonsuicidal Self-Injury Behaviors of Bipolar Disorder

ABSTRACT

The aim of this study was to assess the feature change of nonsuicidal self-injury (NSSI) behaviors in bipolar disorder before and during the pandemic. A total of 115 adolescents with NSSI were evaluated using a Wechsler Intelligence Scale for Children-Fourth Edition, Kiddie Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version, and some related scales. In comparison with the 2017 group, female sex, borderline personality disorder, self-reported internalizing disorders, anxiety/depression, and thinking disorders were all related with the 2021 and 2019 groups. The 2019 group was linked to a variety of somatic issues. Negative life experiences, bullying, eating disorders, social issues, depressed feelings, performance and social anxiety, and rejection sentiments were all linked to NSSI. Both shared and differential features between before and during the pandemic may represent possible change for diagnostic and preventative interventions of NSSI in patients with bipolar disorder. Therefore, the doctor should adjust the treatment strategy based on changing of features between before and during the pandemic.

Effects of mindfulness on stress, life satisfaction, and savoring beliefs among Hong Kong Chinese adolescents during the COVID-19 pandemic

Adolescents all over the world are vulnerable in facing developmental challenges. Recent studies have evidenced that the unexpected interruptions of school learning during the COVID-19 pandemic have raised concerns about the well-being of adolescents. This present study sought to investigate the relationship between mindfulness, stress, savoring beliefs, and satisfaction of life among adolescents in Hong Kong during COVID-19. A total of 240 Hong Kong Chinese adolescents between 15 and 19 years of age (M = 15.60; SD = 0.70) from schools with different religious backgrounds completed an online survey. Findings from hierarchical linear regression indicated that statistically, mindfulness negatively predicted stress and positively predicted life satisfaction and savoring beliefs. Students with faiths did not show any significant differences in mindfulness and other variables in this study from students without faiths. In terms of implications, these findings provide positive evidence that mindfulness may be an important aspect for interventions designed to enhance life satisfaction and savoring beliefs, and reduce stress of adolescents over challenging times. Overall, this study suggests youth service providers to develop effective strategies in schools and communities for further promoting wellbeing and resilience of adolescents.

COVID-19 Pandemic as Subjective Repeated Strains and its Effects on Deviant Behavior in a Sample of Italian Youth

Although over the past 2 years several studies have been carried out on the psychological effects of the COVID-19 pandemic on young people, few of them investigated the pandemic as psychosocial strain and its effects on deviant behaviors. According to Agnew's General Strain Theory, a repeated objective psychosocial strain, such as the pandemic, exerts pressure on deviance when individuals associate with deviant peers and have weak attachment to parents. Using a sample of 568 young Italians (ages: 15-20 years; 65.8% females, 34.2% males) from north, central and south Italy, we tested for the possible correlation between COVID-19 as a repeated psychosocial strain, deviant behaviors and the role of some coping strategies not included in the Agnew's original theoretical formulation. Results back the thesis that, considering the COVID-19 pandemic as a repeated subjective strain, affect deviance results primarily through association with deviant peers and less through weak attachment with family. The mediating role of coping strategies was found to be weak. The predominant role of the peer group in the genesis of deviant responses to strain will be discussed.

The psychosocial consequences of covid-19 in adolescents with nonsuicidal self-injury

BACKGROUND

Young people have been especially affected by the psychosocial consequences of the covid-19 pandemic. Covid-19 has potentially also been more stressful for vulnerable groups with mental health problems.

METHODS

In this cross-sectional study, the psychosocial effects of covid-19 in a vulnerable group of adolescents with nonsuicidal self-injury (NSSI) from a sample of 1602 Swedish high-school students were examined. Data were collected in 2020 and 2021. First, adolescents with and without NSSI were compared on how they perceived the psychosocial impact of covid-19, and second, a hierarchical multiple regression analysis was used to examine whether lifetime NSSI experience was associated with perceived psychosocial consequences of covid-19, when demographic variables and symptoms of mental health problems were controlled for. Interaction effects were also examined.

RESULTS

Significantly more individuals with NSSI reported being burdened by covid-19 compared to those without NSSI. When demographic variables and mental health symptoms were controlled for, adding NSSI experience did not, however, increase the amount of variance explained in the model. The total model explained 23.2% of the variance in perceived psychosocial impact of covid-19. Perceiving the family's financial situation as poor and neither good nor bad, studying a theoretical high school program, symptoms of depression and difficulties with emotion regulation were significantly associated with perceived negative psychosocial impact of the covid-19 pandemic. There was a significant interaction effect between NSSI experience and depressive symptoms. The effect of NSSI experience was larger when depressive symptoms were lower.

CONCLUSIONS

Lifetime NSSI experience in itself was not associated with psychosocial covid-19 consequences when other variables were controlled for, whereas symptoms of depression and difficulties with emotion regulation were. Results imply that vulnerable adolescents with mental health symptoms need special attention and access to mental health support in order to prevent further stress and worsening of mental health symptoms in the wake of the covid-19 pandemic.

Longitudinal associations between pandemic post-traumatic stress symptoms and subsequent non-suicidal self-injury in adolescents: A multiple mediation model

BACKGROUNDS

PTSD is one of the most common conditions after people have experienced trauma. While previous studies have found a link between PTSD and non-suicidal self-injury, (NSSI), few studies have longitudinally explored this relationship and the underlying mechanisms.

AIMS

This study explored adolescent NSSI frequency after COVID-19 lockdown experiences, the relationship with early PTSD symptoms, and the mediating role of depression and sleep problems.

METHODS

A cohort of 1609 adolescents completed two surveys during and after the national lockdown in China; one month into the lockdown and six months later; which assessed demographic and pandemic-related exposure variables; PTSD, depression, sleep, and NSSI. Mediation analyses and hierarchical regression were employed to examine the relationships and the paths between these variables.

RESULTS

The NSSI rate was found to be 31.9 % after the three-month lockdown, with 20.6 % of adolescent participants reporting sleeping disorders, and 33.9 % indicating probable depression. Adolescents who had earlier PTSD symptoms, often smoked and/or drank, and had current depression and sleep disorders reported greater NSSI. Early PTSD symptoms were found to predict later NSSI and were mediated by sleep problems and depressive symptoms. Specifically, PTSD avoidance and numbing symptoms were significantly associated with NSSI above and beyond the depressive symptoms, sleeping problems, and the other covariables.

CONCLUSION

It is necessary to be vigilant about the increased risk of NSSI in adolescents who have experienced extended pandemic lockdowns. Preventing early adolescent PTSD symptoms, especially avoidance and numbness, and helping teenagers quit smoking and drinking could reduce the risk of sleep disorders, depression, and NSSI.

Risky or protective? Online social support's impact on NSSI amongst Chinese youth experiencing stressful life events

BACKGROUND

This study was designed to investigate potential gender differences in the interrelations between different types of stressful life events and non-suicidal self injury (NSSI) among Chinese youth, as well as to test the direct and moderating impacts of online social support on Chinese students' NSSI engagement under the pressure of different types of stressful life events.

METHODS

Based on the data of 2200 students from middle - highschools and universities in Northwestern China, gender difference (male/female binary) in stressful life events, online social support, NSSI and their correlations were analyzed in the study.

RESULTS

Among different types of stressful life events, male students were reported to experience a significantly higher impact of punishment and interpersonal relationship than females. Female students only experienced significantly higher learning pressure than males; Gender difference was not indentified in NSSI among youth; Stressful life events related to punishment could significantly predict NSSI engagement among males. Stressful life events related to learning pressures, interpersonal relationships, and adaption were significantly correlated to NSSI engagement among females; Online social support didn't had a significant direct effect on youth's NSSI, although it did significantly moderate the relationship between specific types of stressful life events (i.e., loss, interpersonal relationships, adaption among males and all types among females) and their NSSI.

CONCLUSION

The present study has provided evidence of specified types of stressful life events being risk factors in affecting youth's NSSI: For male students, the higher impacts of stressful life events related to punishment they experienced, the more likely they were about to engage in NSSI. For female students, stressful life events related to learning pressure, interpersonal relationships and adaption were all proved as significant predictors and risky factors of female youth's NSSI; Online social support did not impact on individual's NSSI engagement directly, but moderated it significantly as a protective factor.

How COVID-19 Phases Have Impacted Psychiatric Risk: A Retrospective Study in an Emergency Care Unit for Adolescents

Dramatic events during the COVID-19 pandemic have acutely impacted the psychosocial environment worldwide, with negative implications for mental health, particularly for more vulnerable children and adolescents with severe psychiatric illnesses. Some data suggest that the pandemic waves may have produced different psychopathological consequences, further worsening in the second phase of the pandemic, compared to those in the first lockdown, soon after March 2020. To test the hypothesis of a further worsening of psychiatric consequences of COVID-19 in the second lockdown compared to the first lockdown, we focused our analysis on a consecutive sample of youth referred to a psychiatric emergency unit for acute mental disorders in the time period between March 2019-March 2021. The sample, consisting of 241 subjects (123 males and 118 females, ranging in age from 11 to 17 years), was divided into three groups: Pre-Lockdown Group (PLG, 115 patients); First Lockdown Group (FLG, 65 patients); and Second Lockdown Group (SLG, 61 patients). Patients in the SLG presented more frequently with non-suicidal self-injuries (NSSIs), suicidal ideation, and suicidal behavior, while no significant differences in self-harm were found between PLG and FLG. Eating disorders were more frequent in both the FLG and SLG, compared to the PLG, while sleep problems were higher only in the SLG. Furthermore, patients in the SLG presented with more frequent psychological maltreatments and neglect, as well as with psychiatric disorders in the parents. Adverse traumatic experiences and internalizing disorders were significantly associated with an increased risk of suicidality. Intellectual disability was less represented from the PLG to SLG, and similarly, the rate of ADHD was lower in the SLG. No differences were found for the other psychiatric diagnoses. This information may be helpful for a better understanding and management of adolescents with severe emotional and behavioral disorders after the exposure to long-lasting collective traumas.

Non-suicidal self-injury and emotional burden among university students during the COVID-19 pandemic: cross-sectional online survey

Owing to restrictions of the COVID-19 pandemic, increased stress is evident in university students with a lifetime history of non-suicidal self-injury (NSSI). Therefore, we examined two groups of university students (n = 174) in an online survey, one that exhibited early NSSI in adolescence (n = 51) and another that exhibited continuous NSSI beyond the age of 18 (n = 123) (German Clinical Trials Register DRKS00023731). We compared the two groups in terms of depressive symptoms in the previous 2 weeks as well as self-perceived changes in emotional burden, urge to self-injure and NSSI frequency in the first year of the pandemic compared with the year before (pre-pandemic). Among other findings, both groups showed an increase in emotional burden and urge to self-injure.

Self-Injury During COVID-19: Views From University Students With Lived Experience

Concerns have been raised about the impact of the COVID-19 pandemic on individuals with lived experience of nonsuicidal self-injury (NSSI). Yet, few efforts have explored this. Accordingly, using a mixed-methods approach, we sought to examine whether emerging adults who have self-injured experienced changes in NSSI urges and behavior during the pandemic and what may have accounted for these changes. To do so, university students with lived experience of NSSI completed online questions asking about NSSI and self-reported changes in urges and behavior since the onset of COVID-19. They then answered open-ended questions asking what contributed to these changes and how they have coped during this timeframe. Approximately 80% of participants reported no change or a decrease in NSSI urges and behavior. Participants discussed removal from stressors (e.g., social stress) that previously evoked NSSI, as well as having time for self-care and to develop resilience as accounting for this. Nevertheless, some participants reported challenges amid the pandemic (i.e., exacerbated stress, isolation); approximately one fifth of participants reported increases in NSSI urges and behavior. Our findings add to recent evidence that many individuals with prior mental health difficulties, including NSSI, can demonstrate resilience in the face of collective adversity. Research and clinician implications are discussed.

Development and Validation of the Self-Rating Suicide Risk Screening Questionnaire

Since suicide is one of the major health problems worldwide, the goal of the present study is to develop a psychometrically sound suicide risk screening tool named Suicide Screening Questionnaire- Self-Rating (SSQ-SR) to quantify the risk of suicidal behavior. The development process includes item generation, item revision and refinement, and validation. A total sample of 2,238 adults in South Korea was used for analysis. The results of factor analysis showed that the SSQ-SR, containing 25 items, supported a three-factor model: "Situational factors," "Negative self-perceptions and mental health factors," and "Suicidal thoughts and behaviors." Also, SSQ-SR showed satisfying internal consistency, concurrent validity and discriminant validity. Lastly, the results of ROC analysis showed a cut-off point of 33.5 for the low-risk group and 36.5 for the high-risk group. Considering these results, the current results demonstrate the SSQ-SR is a valid scale and therefore can contribute to future suicide-related studies and prevention.

The Psychosocial Correlates of Non-suicidal Self-Injury Within a Sample of Adolescents With Mood Disorder

Background

According to the integrated theoretical model, adolescents' behaviors were the outcome of the complex interplay between multiple levels. Non-suicidal self-injury (NSSI) is a serious and high prevalent problem among adolescents with mood disorders. However, a systematic perspective on psychosocial correlates among Chinese clinical adolescents is still rare.

Method

The impact of several factors at the individual (i.e., sex, age, self-esteem, and psychological distress), family (i.e., family structure, family income, and family support), and social level (i.e., living environment, peer support, and teacher support) on the frequency of NSSI behaviors were investigated in the current study. This research included 621 Chinese adolescents with mood disorders from 20 hospitals.

Results

Three-steps hierarchical regression analyses indicated that lower levels of psychological distress and higher levels of self-esteem were most associated with less frequency of NSSI behaviors. In addition, family support was negatively associated with the frequency of NSSI behaviors. After controlling the factors at individual and family levels, no significant association was found between the factors at the social level and the frequency of NSSI behaviors.

Conclusion

These findings provide preliminary support for the notion that adolescent self-esteem and family support may effectively shield them from problematic behavior; nevertheless, adolescents suffering from more emotional pain can be even riskier. Thus, further intervention strategies should consider the non-independence of individual capacities, co-combinatory effects of mood disorder, and family environment in treating those vulnerable Chinese adolescents.

A potential increase in adolescent nonsuicidal self-injury during covid-19: A comparison of data from three different time points during 2011 - 2021

Life-time prevalence of nonsuicidal self-injury (NSSI) has consistently been found to be around 17% in community samples of adolescents. Concerns of threats to mental health in adolescents during covid-19 have been raised. Life-time prevalence of NSSI in high school students in Sweden was compared using the same item to assess NSSI at three different time points. Results showed very similar prevalence of NSSI in 2011 and 2014 (17.2 % vs. 17.7 %), and an increase to 27.6 % during the pandemic of 2020-2021. Our findings imply a need to highlight the potential psychosocial consequences of covid-19 for young people.

The Impact of COVID-19 on Adolescents' Daily Lives: The Role of Parent-Child Relationship Quality

COVID-19 lockdown measures have profoundly impacted adolescent' daily life, with research suggesting an increase in irritability, stress, loneliness, and family conflict. A potential protective factor is parent-child relationship quality; however, no studies have investigated this. We used data from SIGMA, a longitudinal, experience sampling cohort study, in which N = 173 adolescents aged 11 to 20 were tested before and during COVID-19. Multilevel analyses showed decreased daily-life irritability and increased loneliness from pre- to mid-pandemic. Daily-life stress levels were unchanged. Relationship quality was negatively associated with irritability and loneliness and buffered against the increase in loneliness. Effect sizes were small and do not support a strong effect of the first lockdown on irritability, stress, loneliness, and family conflict in adolescents.

The Effect of Cyberbullying, Abuse, and Screen Time on Non-suicidal Self-Injury Among Adolescents During the Pandemic: A Perspective From the Mediating Role of Stress

Adolescence is often a period of turmoil. The COVID-19 pandemic has increased adolescents' difficulty due to mental health consequences that may affect their developmental milestones. This study constructed and empirically tested a theoretical model of three predictive factors (cyberbullying, abuse, and screen time) and stress as the mediating factor in adolescent non-suicidal self-injury (NSSI). Structural equation model (SEM) analysis was applied to investigate stress as a mediating factor in the relationship between adolescent NSSI and cyberbullying, abuse, and screen time. This cross-sectional study used a "crowdsourcing" sample collection method to recruit 464 adolescents aged 11-17 years who were administered a questionnaire comprising scales on cyberbullying, abuse, screen time, stress, and NSSI. All scales had construct reliabilities ranging from 0.759 to 0.958. SEM statistical analysis was performed using Lisrel version 8.8 (Scientific Software International, USA) for Windows (Microsoft Corporation, Redmond, WA, USA). The mean (± SD) age of the cohort was 14.61 ± 1.65 years, and consisted of 66.7% females. Secondary high school was the highest educational background (58%). The study found that cyberbullying and abuse were direct positive predictors (critical t-value for the path > 1.96; p < 0.05) of adolescent NSSI; however, screen time did not have any direct relationship. Furthermore, stress was a significant full mediating factor of screen time and a partial mediating factor of cyberbullying and abuse in the relationship with adolescent NSSI (critical t-value of the path = 5.27; p < 0.05). Cyberbullying, screen time, and abuse with the mediating effect of stress could explain 48% of the variance in adolescent NSSI (R ² = 0.48). Adolescent mental health prevention and promotion programs need to be redesigned during the current COVID-19 pandemic to manage their stress and minimize the mental health consequences of cyberbullying, abuse, and inappropriately increased screen time.

Psychosocial Factors Associated With Increased Adolescent Non-suicidal Self-Injury During the COVID-19 Pandemic

Non-suicidal self-injury (NSSI) in adolescents hospitalized with psychiatric disorders continues to increase after the outbreak of COVID-19. This study aimed to explore the relationship between the pandemic and NSSI among adolescents and whether the composition of psychosocial factors related to NSSI has changed during the pandemic. Through the retrospective analysis of medical records retrieved from the electronic system of the psychiatric hospital located in Chengdu from January 2016 to March 2021, 609 medical records of adolescents were obtained. The main potential psychosocial factors were determined by deductive content analysis. Among the 609 adolescents, 420 subjects had engaged in NSSI, while 189 did not. We found that the percentage of adolescents who had engaged in NSSI in 2016 was only 29.2%, reaching 34.5% in 2017, 45.7% in 2018, 61.3% in 2019, 92.5% in 2020, and 95.9% in 2021. In the binary logistic regression model, female sex (OR = 0.073, 95% CI: 0.028-0.186), older age (OR = 1.234, 95% CI: 1.030-1.478), having a single parent (OR = 7.865, 95% CI: 3.997-15.476), having experienced trauma (OR = 2.192, 95% CI: 1.032-4.654), having experienced social isolation from peers (OR = 8.139, 95% CI: 4.037-16.408), having experienced body-focused bullying (OR = 3.078, 95% CI: 1.295-7.318), overuse of a mobile phone in the parents' opinions (OR = 4.354, 95% CI: 1.380-13.738), having attempted suicide (OR = 9.120, 95% CI: 4.492-18.512), and during the pandemic (time point is January 30, 2020) (OR = 5.399, 95% CI: 1.679-17.357) were the factors that were significantly associated with NSSI. When comparing the differences in psychosocial factors between the pre-pandemic and the during-pandemic groups, the results showed that the family constitution, parent-child relationships, mobile phone overuse, and stressful learning were important factors. Tailored interventions geared towards changed psychosocial factors should be formulated.

Korean University Students' Problematic Alcohol use, Depression, and Non-Suicidal Self-Injury During COVID-19 Lockdown

BACKGROUND

This study investigated depression, problematic alcohol use, and non-suicidal self-injury (NSSI) of university students in Korea during COVID-19 lockdown and evaluated the moderating effect of problematic alcohol use in the relationship between depression and NSSI.

METHODS

In this descriptive cross-sectional study, 234 Korean university students' data were used to analyze the relationship between depression and NSSI and the moderating effect of problematic alcohol use. To analyze the moderating effect, Hayes PROCESS macro (model 1) was used.

RESULTS

Of the participants, 69.7% were problematic alcohol drinkers and 58.1% were binge drinkers. Depression and NSSI scores were 13.948 and 0.901, respectively. Of the participants, 33.3% had experienced NSSI for 6 months. Depression was positively associated with NSSI among university students. Furthermore, problematic alcohol use had a conditional moderating effect on the relationship between depression and NSSI.

CONCLUSIONS

Problematic alcohol use had conditional moderating effects on the relationship between depression and NSSI. Additionally, since the COVID-19 pandemic is ongoing, to prevent NSSI, health care professionals in the university should screen students with problematic alcohol use and depressive symptoms.