Wångby-Lundh Margit, Lundh Lars-Gunnar, Claréus Benjamin, Bjärehed Jonas, Daukantaitė Daiva
Department of Psychology, Lund University, Lund, Sweden.
Child Adolesc Psychiatry Ment Health. 2023 Oct 13;17(1):116. doi: 10.1186/s13034-023-00660-5.
Much longitudinal research has been carried out on non-suicidal self-injury (NSSI) during the last decades, but there still is a lack of studies of the individual developmental pathways of NSSI from adolescence into young adulthood. The aim of the present study was to investigate individual developmental pathways of repetitive non-suicidal self-injury (repNSSI) from adolescence into young adulthood, including adolescent predictors and psychological outcomes in young adulthood. Three developmental pathways were targeted: stable adolescence-limited repNSSI; repNSSI prolonged into young adulthood; and late-onset repNSSI; with no repNSSI as comparison.
Data were taken from a cohort of compulsory school students (N = 1064) in grades 7-8 in a Swedish municipality. The cohort was followed longitudinally, and this study included all individuals (n = 475) with NSSI data from three waves: T1 (when they were 13-15 years old); T2 (one year later); and T3 (ten years later). RepNSSI was operationalized as self-reports of at least 5 instances of NSSI during the past six/twelve months.
The two pathways that involved stable repNSSI were observed significantly more often than expected by chance, with the strongest overrepresentation for the Prolonged RepNSSI pathway. Still, most adolescents who engaged in stable repNSSI stopped this before reaching young adulthood. Those who stopped did not, however, show a significantly better psychological adjustment in young adulthood than those who continued. Compared to participants with no repNSSI, participants who had stopped still reported significantly more stress, anxiety, and emotional dysregulation. As to the prediction of late onset NSSI, the findings were less robust, but sporadic NSSI at T1 and poor sleep at T2 were significant predictors, whereas depressive symptoms fell just short of significance at both timepoints.
The present results indicate that among adolescents who engage in stable adolescent repNSSI (1) significantly more individuals than expected by chance still engage in repNSSI ten years later, and (2) those who stop engaging in repNSSI do not show significantly better psychological adjustment than those who still engage in it. The present findings also indicate that late onset of repNSSI as reported in young adulthood to some extent is predictable from symptom measures ten years earlier.
在过去几十年里，针对非自杀性自伤（NSSI）开展了大量纵向研究，但仍缺乏对NSSI从青春期到青年期个体发展轨迹的研究。本研究旨在调查重复性非自杀性自伤（repNSSI）从青春期到青年期的个体发展轨迹，包括青少年期的预测因素和青年期的心理结果。研究针对三条发展轨迹：稳定的青春期有限repNSSI；持续到青年期的repNSSI；以及晚发型repNSSI；以无repNSSI作为对照。
数据取自瑞典一个市镇7 - 8年级的义务教育阶段学生队列（N = 1064）。该队列进行了纵向跟踪，本研究纳入了所有有三次随访NSSI数据的个体（n = 475）：T1（13 - 15岁时）；T2（一年后）；T3（十年后）。RepNSSI定义为在过去六个月/十二个月内至少有5次NSSI的自我报告。
两条涉及稳定repNSSI的轨迹出现的频率显著高于随机预期，其中持续型RepNSSI轨迹的过度代表性最强。然而，大多数有稳定repNSSI的青少年在成年前就停止了。不过，停止的青少年在成年期的心理调适情况并不比继续的青少年显著更好。与无repNSSI的参与者相比，已停止的参与者仍报告有显著更多的压力、焦虑和情绪失调。关于晚发型NSSI的预测，结果不太可靠，但T1时偶尔出现的NSSI和T2时睡眠不佳是显著的预测因素，而抑郁症状在两个时间点均略低于显著水平。
目前的结果表明，在有稳定青春期repNSSI的青少年中，（1）十年后仍有repNSSI的个体数量显著多于随机预期，（2）停止repNSSI的个体在心理调适方面并不比仍有repNSSI的个体显著更好。目前的研究结果还表明，青年期报告的晚发型repNSSI在一定程度上可根据十年前的症状测量进行预测。
