Prospective prediction of the initiation of non-suicidal self-injury in adolescents with and without depressive Disorders: A US population-based study.

BACKGROUND

Non-suicidal self-injury (NSSI) is common in adolescence and is strongly associated with depressive disorders (DDs), necessitating targeted screening and interventions for NSSI among depressed adolescents. This study aimed to build longitudinal predictive models to identify psychosocial factors distinguishing depressed adolescents who begin engaging in NSSI from those who do not and to compare these predictors with those in youth without DDs.

METHODS

Longitudinal data from the Adolescent Brain Cognitive Development (ABCD) Study were used, incorporating five annual waves (baseline to year-4) for initial participant screening, and using data from year-2 to year-4 follow-ups to prospectively predict NSSI initiation. Separate logistic regression models were constructed to predict NSSI onset among adolescents with DDs over a two-year period based on self-reported (n = 289) and caregiver-reported (n = 401) data. Parallel analyses were conducted among non-depressed adolescents (n = 3562 and 3433 for self-reports and caregiver-reports, respectively). Predictive models were built for self- and caregiver-reported NSSI outcomes.

RESULTS

Common predictors of NSSI initiation across depressed and non-depressed adolescents included being biological female, experiencing social challenges related to sexual minority identity, and holding positive expectancies for tobacco/marijuana. Lifetime suicide ideation uniquely predicted NSSI initiation in non-depressed adolescents. Other significant risk factors varied by depression history, particularly in domains related to temperament and social or relationship experiences.

CONCLUSIONS

Our findings identify distinct and shared risk factors for NSSI initiation in adolescents with and without depression. These results underscore the need for targeted prevention strategies sensitive to adolescents' depression histories.