A cross-sectional matched sample study of nonsuicidal self-injury among young adults: support for interpersonal and intrapersonal factors, with implications for coping strategies

Latent profiles of coping styles and their associations with non-suicidal self-injury in adolescents with social anxiety disorder

Adolescents aged 12-18 with social anxiety disorder (SAD) manifest various emotional and behavioral problems, among which non-suicidal self-injury (NSSI) requires urgent attention. Coping mechanisms for psychological distress significantly impact their vulnerability to NSSI. Understanding the heterogeneity of coping styles among adolescents with SAD can help identify those at high risk for NSSI. However, existing research provides little insight into this matter. This study aims to explore the latent profiles of coping styles in adolescents with SAD and analyze their association with NSSI behaviors. Two hundred and seventy-eight adolescents with SAD were assessed using the Cope-Styles Scale for Middle School Students and the Ottawa Self-Injury Inventor at the clinic. Latent profile analysis was used to analyze their coping styles. The binary logistic regression (using the three-step procedures implemented in the R3STEP auxiliary command) was used to explore sociodemographic predictors of latent coping profiles, such as gender, age, parental marital status, and family economic status. The BCH three-step procedures were employed to analyze differences in NSSI frequency among these profiles. Two profiles were identified, namely the high problem-focused coping group (48.20%) and the low problem-focused coping group (51.80%). Adolescents with SAD in the high problem-focused group had fewer NSSI behaviors than those in the low problem-focused group over the past month (χ2 = 5.598, P = 0.018), past six months (χ2 = 5.996, P = 0.014), and past year (χ2 = 7.171, P = 0.007). In addition, among adolescents with SAD, older age was associated with a significantly lower likelihood of being classified into the low problem-focused coping group (OR = 0.834, SE = 0.070, P = 0.017). Adolescents with SAD who are less inclined to use problem-focused coping strategies are at higher risk of NSSI. Future research should focus on promoting problem-focused coping styles among adolescents with SAD, aiming to help them develop problem-solving skills and enhance their physical and mental health.

The influence of parenting styles and coping strategies on anxiety symptoms in adolescents: a comparative study of groups with and without non-suicidal self-injury behavior

Background

During the COVID-19 pandemic, the global incidence of non-suicidal self-injury (NSSI) has been increasing year by year, especially among adolescents, and it is highly correlated with the level of anxiety among teenagers, particularly within Chinese cultural contexts where parenting styles significantly influence adolescent behavior.

Objective

This study examines the role of culturally-influenced parenting styles and adolescent coping strategies in relation to anxiety and NSSI behavior, aiming to clarify these multivariate interactions for better understanding and intervention.

Methods

A cross-sectional survey was conducted with NSSI-diagnosed adolescents from Affiliated Kangning Hospital, Ningbo, China, and healthy adolescents from urban schools. Data on background, parenting styles, coping strategies, and anxiety levels were analyzed using chi-square tests, independent sample t-tests, MANOVA, and regression analysis.

Results

Adolescents with NSSI reported higher anxiety levels, more punishment and interference, and less emotional warmth from their fathers compared to the non-NSSI group (p < 0.001). The NSSI group also relied more on emotion-oriented coping strategies, while the non-NSSI group favored problem-oriented approaches (p < 0.001). Multivariate analyses confirmed significant effects of NSSI behavior, parenting styles, and coping strategies on anxiety levels.

Conclusion

This study found that the anxiety levels of NSSI adolescents were significantly higher than those of non-NSSI adolescents in China, which was closely related to less emotional warmth from parents, more punishment and interference, and emotion-focused coping strategies. The results demonstrate that family environment and coping strategies play a critical role in NSSI behavior and anxiety levels, highlighting the importance of emphasizing emotional support and positive coping strategies in the prevention and intervention of NSSI behavior.

Daily associations of interpersonal and emotional experiences following stressful events among young adults with and without nonsuicidal self-injury

OBJECTIVES

Emotional and interpersonal dysfunction appears central to nonsuicidal self-injury (NSSI), yet research examining the interplay of these factors among individuals with NSSI is limited. This study aimed to specify such associations before and after daily stressful events among individuals with (vs. without) NSSI.

METHODS

Young adult participants (M_age  = 20.4) with past-year (n = 56) or no history (n = 47) of NSSI completed daily diary assessments over a 2-week period.

RESULTS

No differences in rates of positive or negative interpersonal experiences before or after stressful events were identified. NSSI participants, however, reported greater negative emotion following stressful events compared with non-NSSI participants. The presence (vs. absence) of a positive interpersonal experience following a stressful event was related to lower negative emotional responses only in the NSSI group.

CONCLUSION

Positive interpersonal experiences may downregulate negative emotions following stressful events among individuals with NSSI, highlighting the potential relevance of interpersonal emotion regulation to this population.

Associations of coping styles with nonsuicidal self-injury in adolescents: Do they vary with gender and adverse childhood experiences?

BACKGROUND

The impact of positive coping style on non-suicidal self-injury in adolescents remains unclear, while negative coping style increases the risk of non-suicidal self-injury (NSSI). There is less investigation on gender differences in the impacts of positive coping style and negative coping style on NSSI. It is unknown whether the impacts vary with different levels of adverse childhood experiences (ACEs).

AIMS

To identify gender differences in the impacts of positive coping style and negative coping style on NSSI, and investigate the impacts at different levels of ACEs.

METHOD

An adolescent health survey was conducted in 15 schools in China between November 2013 and January 2014. 9704 students aged 11-19 years completed standard questionnaires to record the details of coping style, NSSI and ACEs.

RESULTS

38.5 % of adolescents had ≥1 NSSI over the past 12 months. NSSI was significantly increased with the low positive coping style in girls with ≥3 ACEs, but not with 0 and 1-2 ACEs, and not in boys with any levels of ACEs. NSSI was increased with high negative coping style in both girls and boys across all ACEs. The negative coping style impact was stronger in girls than in boys (odds ratio 1.66, p < 0.05), especially in those with 1-2 ACEs.

CONCLUSIONS

Adolescents at high risk of NSSI in relation to coping styles should be targeted accordingly. Reducing negative coping style in girls and boys and improving positive coping style in girls who have high ACEs could help prevent NSSI in adolescents.

Nonsuicidal Self-Injury: Increased Prevalence in Engagement

While some suggest nonsuicidal self-injury (NSSI) is increasing, very little has been done systematically to explore this possibility. The current study employed three cohorts of freshman (total N = 949) from the same university across a period of 7 years to explore engagement in NSSI. Related intrapersonal factors were also examined. NSSI lifetime and current engagement use drastically increased across the three cohorts. Anxiety followed a similar trajectory as NSSI behaviors as increasing in reported levels, while depression and coping behaviors did not. Implications of these trends are discussed.

Self-esteem and non-suicidal self-injury in adulthood: A systematic review

BACKGROUND

Non-suicidal self-injury (NSSI) is a self-destructive act that represents a considerable burden on the individual and society. Low self-esteem may be a psychological variable that is related to NSSI. However, little is known about the nature of this relationship in adulthood. This systematic review therefore aimed to provide a synthesis of the available literature on the relationship between self-esteem and NSSI.

METHODS

Articles were independently identified and risk of bias assessed by two reviewers searching PsycINFO, CINAHL, Medline and Web of Science databases. Inclusion criteria were: (1) a mean sample age of eighteen years or over (2) full manuscripts available in English (3) assessment of NSSI (4) assessment(s) of self-esteem. A narrative synthesis of results was undertaken. A random-effects meta-analysis of differences in self-esteem between NSSI and non-NSSI groups was also undertaken.

RESULTS

Seventeen studies were identified and indicated a significant negative relationship between self-esteem and NSSI. The meta-analysis indicated lower self-esteem in those with experiences of NSSI versus those without, d = 0.59 - 1.17. Results suggested that although low self-esteem and NSSI are related in both clinical and non-clinical populations, there are a number of factors which also influence this relationship.

LIMITATIONS

The absence of longitudinal research is a major limitation of this literature.

CONCLUSIONS

It will be important for clinicians to consider the impact of self-esteem in those seeking support for NSSI. Further research should undertake longitudinal research to better understand the self-esteem and NSSI relationship.

The intersection of nonsuicidal self-injury and suicide-related behavior: Patterns of elevated risk and implications for college mental health

OBJECTIVE

To analyze the overlap of nonsuicidal self-injury (NSSI) and suicide-related behaviors (SRB) among college students with regard to demographics, mental health, and coping styles.

PARTICIPANTS

Respondents were 572 undergraduate students at a southwestern public university.

METHODS

Data were collected in 2015. Respondents completed a demographic survey and assessments of NSSI, SRB, internalizing symptoms (ie, anxiety, stress, and depression), aggression, and negative coping strategies. The survey was administered via a Web-based procedure.

RESULTS

Women reported more frequent cutting behaviors than men. Endorsement of NSSI was also associated with an increased likelihood of lifetime SRB. A subgroup of students endorsing both NSSI and SRB demonstrated poorer mental health, more negative coping, and self-reported female sex.

CONCLUSIONS

College healthcare providers may benefit from competency-based training in techniques for the combination treatment of NSSI and SRB, as well as culturally based models of suicide.