Parents\u2019 lived experience of adolescents\u2019 repeated non-suicidal self-injury in China: a qualitative study

Xu Wang,Xuehua Huang,Wenting Zhao,Xia Huang

doi:10.1186/s12888-022-03715-7

Xu Wang, Xuehua Huang + Show 2 more

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https://doi.org/10.1186/s12888-022-03715-7

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Abstract

Background and objectivesThe prevalence of non-suicidal self-injury (NSSI) is high among adolescents. Parents have significant impact on the development of NSSI. Many quantitative studies have demonstrated the relationship between parental factors such as parenting behaviors and adolescents’ NSSI. However, few studies have explored parents’ responses and adolescent-parent reciprocal interaction during repeated NSSI. This study aimed to explore parents’ cognition, behaviors and adolescent-parent reciprocal interaction during repeated NSSI.MethodsThis is a phenomenological study. By purposive sampling, 24 parents of adolescents with repeated NSSI were recruited from a child and adolescent psychiatric ward in a mental health center in Chengdu, China. Semi-structured interviews were conducted and audio-recorded. Audio-recordings were transcribed verbatim and analyzed using thematic analysis.FindingsThree themes were identified: parents’ attribution, perceptions and coping behaviors of NSSI. Chronic stress of adolescents and triggers of NSSI were associated with parental expectations. Parents initially perceived NSSI as a manifestation of puberty, a way of making needs met or a coping strategy of negative emotions, and gradually realized that it was a condition requiring psychological assistance. Parents’ coping behaviors of NSSI were divided into 4 stages, namely denial, dissuasion, reflection and adaptation, and working as a team. To be more specific, parents’ coping strategies at dissuasion stage included criticizing and conciliating, while those at reflection and adaptation stage included neglecting, avoiding conflicts and increasing control.ConclusionsThese findings suggest that adjusting parents’ expectation and negative perceptions of NSSI is beneficial to reduce adolescent-parent conflict and adolescents’ inner conflict and prevent NSSI. Furthermore, it’s necessary to publicize NSSI related knowledge to promote the early detection and treatment of NSSI.

Highlights

Background and objectivesThe prevalence of non-suicidal self-injury (NSSI) is high among adolescents
Chronic stress of adolescents and triggers of NSSI were associated with parental expectations
Through interviews with parents about their experience of adolescents’ repetitive NSSI, 3 themes and 10 sub-themes were identified (Table 2). (1) “Attribution of NSSI” with the sub-themes: chronic stress resulting from parental expectations; triggers. (2) “Perceptions of NSSI” with the sub-themes: a manifestation of puberty; a way of making needs met; a coping strategy of negative emotions; a condition that requires psychological assistance. (3) “Coping behaviors of NSSI” with the sub-themes: denial; dissuasion; reflection and adaptation; working as a team

Summary

Introduction

Background and objectivesThe prevalence of non-suicidal self-injury (NSSI) is high among adolescents. Few studies have explored parents’ responses and adolescent-parent reciprocal interaction during repeated NSSI. This study aimed to explore parents’ cognition, behaviors and adolescent-parent reciprocal interaction during repeated NSSI. Cognitive-Emotional Model [9] explains NSSI at an individual level. Nock [10] took a functional and interpersonal approach, and proposed a Four-Function Model, which believed that NSSI has intrapersonal functions like regulating one’s emotion/cognition and interpersonal functions like communicating with others. In both theoretical models, early life experience, such as childhood maltreatment and familial hostility, contributes to the onset and maintenance of NSSI

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