Non-suicidal self-injury in the context of COVID-19: The importance of psychosocial factors for female adolescents

Background: The COVID-19 pandemic presents a unique context in which to study the impact of protective and risk factors for non-suicidal self-injury (NSSI) in adolescents under circumstances of heightened stress. Methods: Female participants (N = 91, aged 12–16) enrolled in an ongoing study of NSSI completed self-report questionnaires that assessed NSSI recency, internalizing symptoms (anxiety, depressive), stress perception (stress, family conflict, loneliness), and coping resources (emotion regulation, friend and family support). Parents reported on experiences during the pandemic (family's financial status, health, and schooling). We compared protective and risk factors among three groups of adolescents: those with no history of NSSI (Never), those who did not continue to engage in NSSI in the early months of the COVID-19 pandemic (Desist), and those with a history of NSSI who did (Persist). Results: Participants in the Persist group reported higher levels of perceived stress and loneliness and lower family support than those in the Desist group. A larger set of coping resources (emotion regulation difficulties, friend support) also differed between the Persist and Never NSSI groups. These findings largely remained significant when controlling for possible contributing factors. Limitations: A strength is the longitudinal study design. Limitations include the inability to assess changes in rate of NSSI engagement, small sample size, inclusion of only female participants, reliance primarily on self-report, and a design not suitable for making causal inferences. Conclusions: In the context of the COVID-19 pandemic, factors such as family support may protect against NSSI engagement and offer avenues for treatment.