Reciprocal Effect Between Non-suicidal Self-injury and Depressive Symptoms in Adolescence

Background: Non-suicidal self-injury (NSSI) is a common psychological and behavioral problem among adolescents. The COVID-19 pandemic has had a significant impact on people's mental health. To date, few studies have documented the temporal changes in adolescents' psychological status during the pandemic, as well as the impact of large-scale public health intervention strategies. This study contributes to the existing evidence on the subject.

Methods: Participants were 6,023 adolescents aged 10 years and older, with data from two waves of longitudinal surveys, including data for a 7-month interval before and during the pandemic. A cross-lagged model was used to test the bidirectional relationship between NSSI and depressive symptoms in adolescents; logistic regression analysis was used to explore the predictors of NSSI implementation in adolescents with depressive symptoms.

Results: In this study, 32.69% participants reported depressive symptoms at baseline and 34.27% at follow-up; 44.34% participants with depressive symptoms reported NSSI at baseline and 53.44% at follow-up. The duration of the online class, depressed affect, and somatic and related activity were the risk factors for NSSI; sleep duration and positive mood were the protective factors. The lag effect of depression symptoms on NSSI is significant, and so is NSSI on depressive symptoms.

Conclusion: During the COVID-19 pandemic, adolescents' mental health has worsened, resulting in an increase in the prevalence of NSSI among those with depressive symptoms compared to pre-pandemic levels. Early screening for depression is crucial in preventing or decreasing NSSI in adolescents.