Non‐suicidal self‐injury in adolescence: Longitudinal evidence of recursive associations with adolescent depression and parental rejection

Abstract

Introduction: Non-suicidal self-injury (NSSI) has been acknowledged as a major public health concern among adolescents. However, the complex association between parental rejection and NSSI is not entirely understood and the existing literature does not address the underlying mechanism of adolescent depressive symptoms in explaining the process. Methods: Three waves of data (called T1, T2 and T3) were collected 6 months apart, between November 2018 and 2019, in a sample of 1987 Chinese adolescents (56.1% males; ages 10 to 14, M = 12.32, SD = 0.53). Two separate autoregressive cross-lagged models were used to examine the bidirectional association between parental rejection and NSSI as well as the role of depressive symptoms in bidirectional mediation. Results: There was strong evidence of bidirectional effects between parental rejection and NSSI at both 6-month intervals. Parental rejection at T1/T2 positively predicted NSSI at T2/T3, and, vice versa, NSSI at T1/T2 positively predicted parental rejection at T2/T3. Furthermore, we found that the reciprocal association between parent rejection and NSSI was mediated by adolescent depressive symptoms. Conclusions: The present study found reciprocal associations between parental rejection and NSSI, and further demonstrated that the bidirectional process was mediated by depressive symptoms. The indings from this study are of great interest as they help to inform the development of future prevention and intervention strategies for NSSI.Non-suicidal self-injury (NSSI) is deined as direct and deliberate bodily self-harm in the absence of suicidal intent, commonly enacted by self-cutting, self-hitting or self-burning (American Psychiatric Association, 2013). NSSI typically occurs for the irst time around mid-adolescence (Gandhi et al., 2018) and the lifetime prevalence of this behavior is consistently estimated to be approximately 17% among community adolescents (Muehlenkamp, Claes, Havertape, & Plener, 2012;Swannell, Martin, Page, Hasking, & St John, 2014). In recent years, NSSI has been increasingly acknowledged as a major public health concern among adolescents due to its association with signiicant psychological morbidity, including psychological disorders and future suicidal behaviors (

Parent-Adolescent Conflict, Depressive Symptoms, and Non-Suicidal Self-Injury among Chinese Adolescents: The Moderating Effect of the COMT Gene rs4680 Polymorphism

“…This result is congruent with the experiential avoidance model [ 43 ] which postulates that conflict with parents elicits an emotional response (i.e., depressive symptoms) in order to escape to loathsome emotional experiences, which in turn prompted their NSSI. This result is consistent with findings from previous studies that a negative family environment is an important factor for adolescent NSSI via the mediating effect of depressive symptoms [ 14 , 16 , 44 ]. Apart from the overall mediation results, each and every individual link in the mediation model of depressive symptoms is noteworthy.…”

“…Moreover, Valencia-Agudo et al retrieved 39 studies on NSSI indicated that depressive symptoms is observed to prospectively predict future NSSI [ 13 ]. Furthermore, preliminary research suggested that depressive symptoms played an important mediating role between family risk factors (e.g., parental rejection, harsh parenting) and adolescent NSSI [ 14 , 15 , 16 ]. A longitudinal research by Zhu et al, with a sample of 1987 Chinese adolescents, found that parental rejection predicted adolescents NSSI six months later through depressive symptoms [ 14 ].…”

“…Furthermore, preliminary research suggested that depressive symptoms played an important mediating role between family risk factors (e.g., parental rejection, harsh parenting) and adolescent NSSI [ 14 , 15 , 16 ]. A longitudinal research by Zhu et al, with a sample of 1987 Chinese adolescents, found that parental rejection predicted adolescents NSSI six months later through depressive symptoms [ 14 ]. Parent-adolescent conflict may be associated with NSSI via depressive symptoms and not via direct association.…”

Self‐Injury and Domestic Violence in Young Adults During the COVID‐19 Pandemic: Trajectories, Precursors, and Correlates

“…Notably, our models do not provide evidence of causality, and prior research found that the effects between self‐injury and, for example, depressive symptoms can be reciprocal (Zhu, Chen, & Su, 2020 ). Nevertheless, our results support the conclusion that effects operated from stressors to harm, given that all models, including the mediation models, controlled for prepandemic individual differences in self‐injury or violence, respectively, and emotions.…”

Reciprocal longitudinal relations between peer victimization and mobile phone addiction: The explanatory mechanism of adolescent depression

“…We measured adolescents' depression with a 20-item Chinese version (Zhu, Chen, & Su, 2020) of the Center for Epidemiologic Studies Depression Scale for Children (CES-CD) which has been shown good reliability in previous research in China (William et al, 2010). Adolescents were asked to indicate the frequency of their depressive symptoms during the past week (e.g., "I was bothered by things that usually don't bother me").…”