Stressful Life Events in Different Social Contexts Are Associated With Self-Injury From Early Adolescence to Early Adulthood

Abstract

Self-injury often arises as a maladaptive coping strategy used to alleviate distress. Past research has typically examined how chronic stressors in a specific context are associated with self-injury. Little is known about the unique and cumulative associations between acute stressful life events that occur in different social contexts and self-injury among adolescents. This is especially the case for males, for whom the etiology of self-injury is understudied. We examine the unique and cumulative contributions of stressful life events in the contexts of adolescents' school life, peer networks, intimate relationships, and family life to self-injurious behavior in males and females from the community. Our data comes from a prospective-longitudinal community-representative study, the Zurich Project on the Social Development from Childhood to Adulthood (z-proso). Our sample consists of 1,482 adolescents (52% male) assessed at ages 13, 15, 17, and 20. At each age, adolescents reported whether they had engaged in self-injury during the previous month. They also reported stressful life events in the school, peer, intimate relationships, and family contexts, typically since the last assessment. Stressful life events in the peer context were consistently associated with self-injury. In the contexts of school, intimate relationships, and family, some associations were age-or sex-specific. For example, mid-adolescent females were more likely than mid-adolescent males to use self-injury when faced with stressful events in school and intimate relationships. With respect to risk accumulation, females' risk of self-injury increased with each additional life event between the ages of 13 and 17, beginning at 2+ events. This pattern did not hold for males. In early adulthood, 4+ life events were associated with an increased risk of self-injury, which suggests that the thresholds for the number of life events needed to trigger self-injury increased from adolescence to young adulthood. Our findings suggest that reducing risk of stressful events in different social contexts, and improving young people's coping skills could help reduce their risk of self-injury. New or revised theoretical models may be needed to better understand the emergence of self-injury in males.

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

“…In a prior study based on the same sample used here, we found that some secondary consequences of the pandemic (e.g., economic disruptions) increased the risk of young adults' perceived stress, internalizing symptoms, and anger (Shanahan et al., 2020 ). While the experience of one stressor at a time may be relatively manageable, an accumulation of stressors is likely to become so stressful that engagement in maladaptive behaviors is increasingly likely (Appleyard, Egeland, Van Dulmen, & Sroufe, 2005 ; Steinhoff, Bechtiger, Ribeaud, Eisner, & Shanahan, 2020 ). However, the associations of (1) cumulative pandemic‐related stressors (e.g., exposure to the disease, financial difficulties, disruptions of work and educational arrangements) and (2) prepandemic stressors (e.g., stressful life events) with during‐pandemic self‐injury and domestic violence have not been examined.…”

Cohort Profile: The Zurich Project on the Social Development From Childhood to Adulthood (Z-Proso)

“…Several z-proso studies have specifically examined internalising symptoms, self-harm, and suicidality, with a focus on the transition from early adolescence to early adulthood. One study showed that 27% of young people reported self-harm at least once between ages 13 and 20 (Steinhoff et al, 2020). Precursors of recurrent self-harm included early internalising symptoms and early self-injury onset (Steinhoff et al, 2021).…”

“…Precursors of recurrent self-harm included early internalising symptoms and early self-injury onset (Steinhoff et al, 2021). The risk of self-harm increased with an increasing number of life events (Steinhoff et al, 2020). Less than half of the adolescents with self-injury contacted mental health services (Steinhoff et al, 2021).…”

Sickness and the Social Brain: Love in the Time of COVID

“…Sex differences in susceptibility to social isolation and social stress are also observed during the adolescent period. In humans, adolescent girls are more likely than adolescent boys to be sensitive to social stress, become depressed, or to engage in self-injurious behavior following stress in peer and/or family relationships ( 191 , 192 ). In adolescent male mice, social isolation during adolescence leads to impaired social recognition memory in adulthood ( 193 ).…”