The Effect of Mental Health Status and Family Function on Nonsuicidal Self-Injury: A Longitudinal Analysis of Chinese Children and Adolescents

Yuxin Chen,1,2,* Rui Hu,1,* Xinmao Xu,1 Binxue Hong,1 Jinquan Zhang,1 Peng Jia,3,4 Li Zhao1,2,4 1West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China; 2China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, People’s Republic of China; 3School of Resource and Environmental Sciences, Wuhan University, Wuhan, People’s Republic of China; 4International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Li Zhao, Email zhaoli@scu.edu.cnBackground: Nonsuicidal self-injury (NSSI) is an overwhelming social problem in children and adolescents. Focusing on the change of NSSI behavior, including onset, cessation, and maintenance, is crucial to developing effective prevention and intervention strategies. This study explored the effect of mental health status (depressive and anxiety symptoms) and family function on NSSI.Methods: The study sample comprised 7554 children and adolescents based on the first two rounds of the Chengdu Positive Child Development (CPCD) dataset in China. Depressive and anxiety symptoms measured mental health status. The self-reported questionnaires also assessed NSSI behaviors and family function. The interrelationship between NSSI behaviors, mental health status, and family function was evaluated. Logistic regression and linear regression were performed to examine the interrelationship between mental health status, family function and NSSI behaviors. Sensitivity analysis was performed.Results: In this study, 2167 (28.69%) participants reported NSSI at baseline and 2101 (27.81%) at follow-up. Depression, anxiety, and family function were salient influential factors in the prevalence, onset, and cessation of NSSI. Parents’ accompaniment showed a significant effect on the prevalence of NSSI.Conclusion: Depression, anxiety, family function, and parents’ accompaniment are all associated with NSSI behaviors. Strategies targeting mental health status and family function could effectively protect children and adolescents from NSSI behaviors.Keywords: nonsuicidal self-injury, NSSI, depression, anxiety, family function, children, adolescent