Stop self-injuring, then what? Psychosocial risk associated with initiation and cessation of nonsuicidal self-injury from adolescence to early adulthood.

Abstract

Nonsuicidal self-injury (NSSI) typically begins in adolescence and remits by early adulthood, but few prospective studies have investigated the long-term impact of NSSI initiation and cessation on young people's wellbeing. We examined changes in psychosocial risk associated with NSSI onset and offset in an accelerated longitudinal study of 662 adolescents (12-18 years old) who were followed biennially for 10 years. Of the 133 participants who reported NSSI, 100 had stopped engaging in NSSI by the study's end. NSSI initiation was associated with concurrent increases in depression, anxiety, externalizing symptoms, peer victimization, alcohol, tobacco and illicit substance use, and concurrent declines in physical self-concept, parent, and peer support. As NSSI persisted, youth experienced further increases in anxiety and cannabis use, and declines in physical self-concept. NSSI cessation was associated with concurrent increases in alcohol, cannabis, and tobacco use. With sustained cessation, however, youth experienced gradual improvements in depression, anxiety, externalizing symptoms, peer victimization, as well as gradual reductions in alcohol and tobacco use. By early adulthood, participants who reported ongoing NSSI worked fewer hours and were more likely to delay medical treatment for financial reasons versus those without NSSI histories, and reported less environmental mastery versus those who had discontinued NSSI. Youth who had discontinued NSSI, in turn, reported less environmental mastery and self-acceptance versus youth who never engaged in NSSI. These results contextualize NSSI cessation alongside indicators of psychological, social, and behavioral wellbeing, and underscore the persistence of psychosocial vulnerability after NSSI has resolved. (PsycInfo Database Record (c) 2022 APA, all rights reserved).