Latent transition analysis of non-suicidal self-injury comorbidity patterns among adolescents: predictive roles of impulsivity, emotional dysregulation, and core self-evaluations

Abstract

Despite evidence that non-suicidal self-injury (NSSI) co-occurs with both emotional and behavioral problems in adolescence, little research has addressed their tripartite comorbidity. This study employed a person-centered approach to identify heterogeneous comorbidity patterns of NSSI with multiple emotional and behavioral problems, assess their stability and transitions, and explore associated risk and protective factors. A total of 3704 adolescents (57.1% males; Mage = 14.0, SD = 0.83) participated in a two-wave, nine months study. Three distinct patterns were identified, including one Low-symptoms and two comorbidity patterns, namely the Emotion-dominant, Low-NSSI Comorbidity and NSSI-dominant, High-symptoms Comorbidity. Across time, adolescents showed three directions of change as stability, symptoms improvement, and symptoms worsening. Moreover, adolescents with higher impulsivity and emotional dysregulation were more likely to be classified into the comorbidity patterns, whereas those with higher core self-evaluation were less likely to belong to the comorbidity patterns. Longitudinally, higher core self-evaluation reduced the likelihood of symptoms worsening. These findings reveal the heterogeneous and fluid nature of the tripartite comorbidity among NSSI, emotional problems, and behavioral problems, and point to the value of integrative interventions that target emotion regulation, impulse control, and core self-evaluation.