Psychosocial Factors Associated With Increased Adolescent Non-suicidal Self-Injury During the COVID-19 Pandemic

Abstract

Non-suicidal self-injury (NSSI) in adolescents hospitalized with psychiatric disorders continues to increase after the outbreak of COVID-19. This study aimed to explore the relationship between the pandemic and NSSI among adolescents and whether the composition of psychosocial factors related to NSSI has changed during the pandemic. Through the retrospective analysis of medical records retrieved from the electronic system of the psychiatric hospital located in Chengdu from January 2016 to March 2021, 609 medical records of adolescents were obtained. The main potential psychosocial factors were determined by deductive content analysis. Among the 609 adolescents, 420 subjects had engaged in NSSI, while 189 did not. We found that the percentage of adolescents who had engaged in NSSI in 2016 was only 29.2%, reaching 34.5% in 2017, 45.7% in 2018, 61.3% in 2019, 92.5% in 2020, and 95.9% in 2021. In the binary logistic regression model, female sex (OR = 0.073, 95% CI: 0.028–0.186), older age (OR = 1.234, 95% CI: 1.030–1.478), having a single parent (OR = 7.865, 95% CI: 3.997–15.476), having experienced trauma (OR = 2.192, 95% CI: 1.032–4.654), having experienced social isolation from peers (OR = 8.139, 95% CI: 4.037–16.408), having experienced body-focused bullying (OR = 3.078, 95% CI: 1.295–7.318), overuse of a mobile phone in the parents' opinions (OR = 4.354, 95% CI: 1.380–13.738), having attempted suicide (OR = 9.120, 95% CI: 4.492–18.512), and during the pandemic (time point is January 30, 2020) (OR = 5.399, 95% CI: 1.679–17.357) were the factors that were significantly associated with NSSI. When comparing the differences in psychosocial factors between the pre-pandemic and the during-pandemic groups, the results showed that the family constitution, parent–child relationships, mobile phone overuse, and stressful learning were important factors. Tailored interventions geared towards changed psychosocial factors should be formulated.

Psychopathological and Interactive-Relational Characteristics in Non-Suicidal Self-Injury Adolescent Outpatients

“…Our study represents one of few studies that deepen interactive-relational characteristics of NSSI adolescents before the pandemic period. As confirmed by recent studies, non-suicidal self-injury in adolescents has significantly increased after the outbreak of COVID-19 [ 45 , 46 ] and worse family and parent-children relationships appear strongly related as predisposing factors [ 47 ].…”

Repercussions of the COVID-19 pandemic on child and adolescent mental health: A matter of concern—A joint statement from EAP and ECPCP

“…Most of the studies reported that the stress that children and adolescents have been subjected to, due to school closures and social distancing during the pandemic, impacted their mental health producing negative and different side effects ( 20 – 23 ), depending on their age, gender, ethnicity, family circumstances, socioeconomic situation ( 22 , 24 ). Greater negative effects on any pre-existing mental health problem ( 25 ) and heavier mental health outcomes were found in those who already had poor mental health before the COVID-19 pandemic ( 26 , 27 ). Furthermore, countries' health outcomes were influenced by local political decisions and media intervention, following public reactions, allowing for a major difference in morbidity and mortality within and between countries.…”

Factors influencing the addiction characteristics of non-suicidal self-injurious behaviors in adolescents: A case-control study

“…In contrast, during the COVID-19 outbreak (February 28 to March 11, 2020), data from the Taiwan Province of China found that the prevalence of NSSI among junior high school students was 40.9% ( 12 ). Simultaneously, the proportion of NSSI among hospitalized adolescents with mental disorders in China has increased from 29.2% in 2016 to 92.5% in 2020 and 95.9% in 2021 ( 13 ).…”