Triggering And Protective Factors Of Non-Suicidal Self-Injury Among Adolescents

Non-suicidal self-injury behavior is a dangerous behavior that is not accepted by the society.It is an independent risk factor of suicide.Self-injurious thoughts usually occur before self-injury,and it is one of the precursors of self-injury.It may provide an important intervention point before self-injury occurs,and has important clinical value.The ecological investigation of the situational factors and process of self-injurious thoughts will help to further understand the risk factors and protective factors of self-injury.This paper contains two studies which focus on the occurrence and development of self-injurious thoughts and behaviors.Study 1 used ecological momentary assessment to investigate the basic forms,environmental factors,triggering factors and predictors of self-injurious thoughts and behaviors.A total of 35 adolescents were recruited to complete online questionnaires three times a day for two weeks,and 1320 valid questionnaires were obtained.Among them,29 participants reported 163 self-injurious thoughts and 18 participants reported56 self-injurious behaviors.The results show that self-injurious thoughts can occur at any time of the day,usually lasting 10-30 minutes or 1-10 minutes,while self-injurious behaviors usually last 1-10 minutes.The triggers of self-injurious thoughts are mostly interpersonal conflicts and academic pressure,followed by perceived criticism,perceived control and perceived rejection.Sometimes they can be caused by inexplicable negative emotions.When objective conditions are insufficient or they subjectively do not want to hurt themselves,the participants would use strategies such as diverting attention,deep breathing or self-comfort to restrain the urge,or they just cry or endure,waiting for the urge to decline.Self-injurious thoughts gradually decrease with age and are not affected by location or status.The mental processes of self-injurers were explored through 14 semi-structured interviews and the protective factors of self-injury were discussed in study 2.The study found that in addition to traumatic events and long-term academic stress,some common frustration and obstacles,even noisy environment or temporal physical discomfort can also lead to self-injurious thoughts.When witnessed the self-injury behaviors of peers,although they were surprised or afraid at that time,they may also unconsciously imitate the behavior.Self-injurers sometimes restrain the urge when they don’t have appropriate tools,or are around others,or are afraid of being worried,scolded or misunderstood by others.Some self-injurers tried to restrain the urge because they thought the behavior should not occur.But generally speaking,their coping strategy is relatively negative.The frequency of self-injurious thoughts and behaviors is not fixed,but can be reduced slowly with the reduction of stimulus sources,the improvement of mood or the maturity of mentality.Relaxed environment,understanding and support from parents,self-compassion,sense of meaning and value,improvement of coping strategies,emotion release,focusing on positive things,medication and psychological therapy are long-term protective factors of self-injury.