Psychosocial Outcomes From COVID-19 Not Pronounced Among Adolescents With NSSI

Psychosocial consequences from COVID-19 more greatly affected adolescents with depression and emotional regulation difficulties than those with a history of nonsuicidal self-injury (NSSI). These study results were published in Child and Adolescent Psychiatry and Mental Health.

Third-year high school students (N=1602) attending 110 schools in Sweden were recruited during home study between 2020 and 2021. In 3 waves, students were sent questionnaires about the psychosocial effects of COVID-19.

The study population comprised 56.4% girls, they had a mean age of 18.1 (SD, 0.6) years, 70.3% were in a theoretical study program, 88.0% of their mothers worked, 87.1% of their fathers worked, 76.2% had a good family financial situation, and 62.2% were living with both parents.

Overall, 488 individuals reported a history of NSSI. The NSSI group had a higher proportion of girls, more were enrolled in practical study, fewer reported a good family financial situation, and fewer lived with both parents compared with those reporting no NSSI (all P <.001).

In the survey, more individuals with NSSI agreed that COVID-19 affected them a lot (74.8% vs 68.1%; P =.02), they felt more alone than before (55.5% vs 38.5%; P <.001), they found discussions about worries with friends more difficult (32.2% vs 18.0%; P <.001), they found it more difficult to contact nonfamily adults to discuss worries (32.0% vs 17.0%; P <.001), they were more worried about their home situation (20.9% vs 7.1%; P <.001), their support or treatment was interrupted (24.0% vs 8.8%; P <.001), and they felt at-home education was not working for them (42.2% vs 307%; P <.001) compared with the non-NSSI group, respectively.

Despite these trends, self-reported NSSI did not predict negative psychosocial consequences from COVID-19 (t, 1.44; P =.15).

Predictors for perceiving negative psychosocial outcomes included self-reported depression (t, 5.86; P <.001), self-reported difficulties with emotional regulation (t, 5.23; P <.001), enrollment in a theoretical study program (t, 2.84; P =.005), having a neutral family financial situation (t, 2.42; P =.02), and a poor family financial situation (t, 2.24; P =.03).

These characteristics explained 23.2% of the variance in perceived impacts from COVID-19 (F_[12,1589], 40.09; P <.001) and the fit of the model was not improved by adding NSSI (P =.015).

In an interaction and moderator analysis, a significant interaction between depressive symptoms and NSSI on COVID-19 consequences was observed (β, -0.21; P <.001) but not between emotional regulation difficulties and NSSI (β-0.04; P =.05).

The major limitation of this study was that the cross-sectional design did not allow for causative inferences to be made.

Study authors concluded, “[A]dolescents with experience of NSSI perceived more negative psychosocial consequences of [COVID-19] than adolescents without NSSI experience. In this cross-sectional study, NSSI experience in itself did not, however, independently predict psychosocial [COVID-19] consequences when other variables were controlled for, whereas other variables, such as symptoms of depression and difficulties with emotion regulation did.”