The Destructive Courage: A Longitudinal Analysis of How Harsh Parenting Leads to Adolescent Non-Suicidal Self-Injury

BackgroundPrevious studies have suggested that negative parenting environments, especially harsh parenting, are a specific risk factor for non-suicidal self-injury (NSSI). However, the potential mechanism between harsh parenting and NSSI has not been explored. Based on the experiential avoidance model and empirical research, we aimed to examine whether depressive symptoms are a mediator between harsh parenting and NSSI. Moreover, the catechol-O-methyltransferase (COMT) Val158Met polymorphism related to depressive symptoms may also exert a moderating effect on NSSI; thus, the interaction between harsh parenting and COMT was also considered in our study.MethodsA total of 373 junior high school students were recruited for the study by using a longitudinal design. The adolescents answered self-report questionnaires and provided saliva samples for DNA genotyping.ResultsThe results revealed that harsh parenting was positively associated with NSSI after 24 months, and this association was mediated by depressive symptoms. Moreover, the moderating role of COMT in the direct and indirect effects of harsh parenting on NSSI was observed only among adolescents with two Val alleles and the relationship was not significant for Met carriers.ConclusionsGenetic variations of COMT Val158Met may be a critical candidate in understanding the development of depression and NSSI. We conclude that Val homozygotes of the COMT Val158Met polymorphism play a role in susceptibility to both depressive symptoms and NSSI.

Harsh parenting and adolescent non-suicidal self-injury: A moderated mediation model of alienation and cognitive reappraisal

Previous research has shown that an increase in identity confusion is associated with a higher risk of non-suicidal self-injury (NSSI) in adolescents. Based on the identity-NSSI interplay model, we tested psychological distress as a mediator of this association. Based on the life history theory, we tested whether a slow life history strategy could weaken this mediation process. Five hundred and eighty-two Chinese middle school students (Mage = 13.75, SD = 0.67) completed questionnaires regarding identity confusion, psychological distress, life history strategy, and NSSI in May 2024. The results of structural equation modeling showed that identity confusion significantly predicted adolescent NSSI, and psychological distress mediated the association. Life history strategy moderated the second stage of the indirect effect (i.e., the relationship between psychological distress and NSSI). Specifically, the slower the life history strategy, the weaker the indirect effect of identity confusion on NSSI through psychological distress. These findings highlight the value of integrating life history strategy into research on adolescent NSSI.

Non-suicidal self-injury in adolescents: Prevalence and associations with identity formation above and beyond depression

Non-suicidal self-injury (NSSI) is highly prevalent in adolescents. Secure attachment with family and peers can reduce vulnerability to NSSI and can optimize the outcomes of developmental challenges such as identity formation. Problems experienced in these developmental processes and contexts can increase vulnerability to NSSI. Hence, the present study examined associations between attachment with mother and peers, identity formation, and NSSI, using self-report questionnaires in 528 high school students (Mean age = 15.0 years, SD = 1.84, 11–19 years, 50.4 % females). The lifetime prevalence of NSSI was found to be 14.2 %. Mediation analyses indicated that peer trust had a significant negative indirect effect on NSSI via identity synthesis and confusion. The positive association between peer alienation and NSSI was partially mediated by a lack of identity synthesis. Further, the pathways from maternal trust and alienation to NSSI were fully mediated by both identity confusion and synthesis. Clinical implications and suggestions for future research are discussed.

Non-suicidal self-injury (NSSI) and suicidality in adolescents represent urgent public health concerns. Although distinct, these behaviors share several underlying mechanisms. To clarify their relationship and inform prevention strategies, it is crucial to identify the factors most strongly associated with NSSI and suicidality in early adolescence, as well as those that exert common influences on both. In this study, a survey of 625 Chinese early adolescents (Mage = 10.36 years, SD = 0.93 years) was conducted, and network analysis was used to examine the interconnections among NSSI, suicidal ideation, suicide attempts, and multiple influencing factors. Results showed that harsh parenting, interparental conflict, and perceived burdensomeness were central factors for the concurrent prevention and intervention of NSSI, suicidal ideation, and suicide attempts. Furthermore, meaning in life and deviant peer affiliation emerged as important factors influencing both NSSI and suicidal ideation. These findings provide a robust theoretical foundation and practical direction for the early identification and mitigation of adolescent NSSI and suicidality.

Childhood emotional abuse and adolescent nonsuicidal self-injury: The mediating role of identity confusion and moderating role of rumination

Poor emotion regulation has been implicated in the occurrence of non-suicidal self-injury (NSSI), yet how this affects adolescent self-injury is not well understood, particularly in light of changes in emotion regulation during adolescence. The set of three empirical studies reported in this thesis aimed broadly to examine the roles of three emotion regulation processes (cognitive reappraisal, expressive suppression and rumination) in NSSI among adolescents. Together, these studies investigated how the emotion regulation processes of interest were related to NSSI, and in particular, to its onset and on-going severity as assessed by frequency, duration and medical seriousness of methods used. Method: Data from 3,143 predominantly female high school students (aged 12-18 years), recruited from Australian secondary schools, were analysed. Of these, 555 indicated they had a history of NSSI. Mean age of onset ranged from 12-14 years, with most participants reporting they had engaged in NSSI in the twelve months preceding data collection. Reported frequency of NSSI ranged from one to 300 times. Cutting and hitting oneself were the most common forms of NSSI although a range of methods and multiple methods were reported. Results: Adolescents who engaged in NSSI were more likely, compared to their non-self-injuring peers, to use emotion regulation processes which tend to heighten negative emotional states (i.e. expressive suppression and rumination) rather than those which can potentially reduce these emotions (i.e. cognitive reappraisal). Nonsignificant differences in the trajectories of these processes across the study period suggest similar developmental patterns between groups. However, self-injurers were more likely to have experienced more adverse life events. Taken together, these findings suggest adolescents who self-injure are more vulnerable and less prepared to respond effectively to the emotional challenges they experience. This observation is especially pertinent in NSSI onset where acute life stressors increased risk of engaging in NSSI for the first time (but were not related to NSSI severity) and echoes the general consensus that adolescent self-injury is associated with deficits in emotion-focused coping and difficulties with emotion regulation when faced with adversity. A hypothesised model that specified the relationships between adverse life events, psychological distress and NSSI were each moderated by the emotion regulation processes of interest was only minimally supported. While this indicated direct effects were more pertinent, only cognitive reappraisal emerged as a significant predictor of future NSSI. Reappraisal was protective of first episode NSSI occurring 12-months from baseline but not at 24-months. Increasing use of cognitive reappraisal was also related to decreasing NSSI severity (i.e. frequency, duration, medical severity) over a two-year period. Findings on the contribution of reappraisal in NSSI onset and its escalation over time hint at the influence of developmental changes in these relationships. Conclusion: Results emphasised different processes are implicated in engaging in NSSI for the first time, and in the overall severity of the behaviour. Adolescents may engage in NSSI as a response to emotional distress, however behavioural contingencies are likely more relevant in the maintenance and escalation of the behaviour. In both instances, addressing adolescents’ appraisals of stressful situations and life events, including the meanings they attribute to them, is likely to be beneficial. Implications for interventions addressing adolescent NSSI across the spectrum of prevention and treatment are discussed.

Non-suicidal self-injury in female adolescents and psychiatric patients: A replication and extension of the role of identity formation

The relationship between negative life events, life satisfaction, and nonsuicidal self-injury has been demonstrated in adolescence, but no study has examined the longitudinal associations between the three over time. The present study hypothesized that negative life events play a mediating role in the relationship between life satisfaction and non-suicidal self-injury over time. A total of 268 junior high school students participated in three questionnaires with an interval of half a year and completed questionnaires investigating the Adolescents Self-Harm Scale, the Adolescent Self-Rating Life Events Checklist, and the Satisfaction with Life Scale. The results indicated a significant predictive role of negative life events in non-suicidal self-injury over time and the prospective effect of life satisfaction on negative life events in adolescence. Negative life events play an intertemporal mediation in the relationship between life satisfaction and non-suicidal self-injury. As a clear non-suicidal self-injury risk factor, negative life events can significantly predict non-suicidal self-injury in adolescence whether it is horizontal or vertical. Junior high school students who are exposed to more negative life events are more likely to have non-suicidal self-injury behaviors and the negative life events have a certain lagging effect on non-suicidal self-injury. Due to the prospective effect of life satisfaction on negative life events in adolescents, negative life events play a mediation in the relationship between life satisfaction and non-suicidal self-injury over time.

Adolescents' deliberate self-harm, interpersonal stress, and the moderating effects of self-regulation: A two-wave longitudinal analysis

Based on the integrated theoretical model of the development and maintenance of non-suicidal self-injury (NSSI) and gender role theory, this study investigated the longitudinal impact of the need for uniqueness on NSSI among adolescents, and the mediating role of depression and the moderating role of gender. A total of 1,166 middle school students (Mean age = 13.04, SDage = 0.78, range = 11-16) from a city in central China was recruited to complete the Need for Uniqueness Scale, Depression Scale, and Adolescent Self-Injury Questionnaire at two waves. The participants included 475 boys and 457 girls. Convenience sampling was used, and a longitudinal study (2 time points with a 6-month interval) was conducted to test our hypotheses. SPSS 25.0 was used to evaluate reliability, and to calculate descriptive statistics and Pearson correlation. PROCESS version 3 was used to test longitudinal relationships among the need for uniqueness, depression and NSSI, and construct a moderated mediation model. Results revealed that T1 need for uniqueness in adolescents was significantly positively associated with T2 NSSI and T2 depression, and T2 depression was significantly positively associated with T2 NSSI. After controlling for gender, T1 need for uniqueness positively predicted T2 NSSI. Furthermore, the mediation analysis demonstrated that the pathway linking T1 need for uniqueness to T2 NSSI through T2 depression was statistically significant. Moreover, gender moderated the indirect effect from T2 depression to T2 NSSI in the association between T1 need for uniqueness and T2 NSSI. Compared to boys in the same situation, girls who are susceptible to depression were more likely to commit NSSI. This study demonstrated that the need for uniqueness in adolescents longitudinally predicts NSSI through the mediating role of depression and gender moderates the indirect effect from depression to NSSI. The current study not only suggests that the need for uniqueness is a risk factor for NSSI among adolescents, but also provides an empirical basis for the prevention and intervention of NSSI.

ObjectiveWe aimed to investigate the characteristics and psychological mechanism of non-suicidal self-injury (NSSI) in adolescents with mood disorders. We examined how self-compassion and emotional regulation affected NSSI and tested the mediating role of self-compassion in the link between emotional regulation and NSSI.MethodWe recruited outpatient and inpatient adolescent patients with bipolar and related disorders or depressive disorders (DSM-5), with a focus on NSSI. We also recruited healthy controls from the community. We collected demographic and clinical data. The Adolescent Self-injury Questionnaire, Self-compassion Scale (SCS), and Emotion Regulation Questionnaire (ERQ) were used to assess the frequency and severity of NSSI, level of self-compassion, and emotional regulation.ResultsIn total, we recruited 248 adolescent patients with mood disorders (N = 196 with NSSI, and 52 without NSSI) and 212 healthy controls. NSSI was significantly associated with the female sex, lower levels of education and less use of cognitive reappraisal strategies, lower levels of self-warmth, and higher levels of self-coldness. Multivariate analysis of variance showed that there were significant differences in the scores of ERQ, cognitive reassessment score, and the scores of SCS among the three groups, but no statistical differences in expressive suppression score among the three groups. Self-warmth had a mediating effect between cognitive reappraisal and NSSI behavior.ConclusionNSSI is prevalent among adolescent patients with mood disorders in clinical settings, especially among girls and those with lower levels of education and less cognitive reappraisal strategies. More clinical attention is needed. Self-compassion and its factors may mediate the association between emotional regulation and NSSI. Clinical implications and future research directions were discussed.

The influence of relationship loss on non-suicidal self-injury in adolescence: The mediating effects of perceived opportunity in adversity and PTSD symptoms.

Non-suicidal self-injury (NSSI) is a serious and alarming phenomenon during adolescence. There is a need for understanding the intrapersonal variables that might contribute to the maintenance of these self-injurious behaviors. This study aims to concurrently compare intrapersonal variables between adolescents with and without a lifetime history of NSSI, and to longitudinally test whether NSSI over lifetime history predicts 6-months NSSI through self-criticism and depressive symptoms among Portuguese adolescents with a self-reported history of NSSI. Adolescents (N = 418, 12–19 years-old) from middle and secondary schools completed self-report questionnaires to assess self-criticism (particularly, the most severe form: hated self), depressive symptoms, and the frequency of NSSI in two points in time over the 6-months interval. Adolescents who reported a lifetime history of NSSI tend to experience greater harsh and persecutory criticism towards themselves and elevated depressive symptoms than adolescents without a history of NSSI. Results from path analysis showed that lifetime NSSI predicts subsequent NSSI, and this association is mediated by self-hatred and depressive symptoms among adolescents with lifetime NSSI. Findings suggest that NSSI is maintained through a sense of self-focused on hatred and disgust feelings and depressive symptoms.