Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset

Abstract

Background: Adolescence is characterized by developmental changes in social relationships, which may contribute to, or protect against, psychopathology and risky behaviors. Non-suicidal self-injury (NSSI) is one type of risky behavior that typically begins during adolescence and is associated with problems in relationships with family members and peers. Prior research on social factors in adolescent NSSI has been limited, however, by a narrow focus on specific interpersonal domains, cross-sectional methods, retrospective self-report of childhood experiences, and a failure to predict NSSI onset among as-yet-unaffected youth.

Methods: We investigated these relationships in 2127 urban-living adolescent girls with no NSSI history at age 13, who were participating in a longitudinal cohort study (Pittsburgh Girls Study). We used discrete-time survival analyses to examine the contribution of time-varying interpersonal risk factors, assessed yearly at ages 13-16, to NSSI onset assessed in the following year (ages 14-17), controlling for relevant covariates, such as depression and race. We considered both behavioral indicators (parental discipline, positive parenting, parental monitoring, peer victimization), and cognitive/affective indicators (quality of attachment to parent, perceptions of peers, and perceptions of one's own social competence and worth in relation to peers) of interpersonal difficulties.

Results: Parental harsh punishment, low parental monitoring, and poor quality of attachment to parent predicted increased odds of subsequent adolescent NSSI onset, whereas positive parenting behaviors reduced the odds of next year NSSI onset. Youth who reported more frequent peer victimization, poorer social self-worth and self-competence, and more negative perceptions of peers were also at increased risk of NSSI onset in the following year. When tested simultaneously, no single parenting variable showed a unique association with later NSSI onset; in contrast, peer victimization and poor social self-worth each predicted increased odds of later NSSI onset in an omnibus model of peer and parent relationship characteristics.

Conclusions: In this urban sample of adolescent girls, both peer and parent factors predicted new onset NSSI, although only peer factors were associated with subsequent NSSI in combined multivariate models. Results further suggest that both behavioral and cognitive/affective indicators of interpersonal problems predict NSSI onset. These findings highlight the relevance of family and peer relationships to NSSI onset, with implications for prevention of NSSI onset among at-risk youth.

Keywords: Adolescence; Discrete-time survival analysis; Family; Longitudinal modeling; Non-suicidal self-injury; Parenting; Relationships; Social.

Fig. 1

Path diagram of proportional and nonproportional discrete-time survival models. Top figure shows a proportional model, in which the time-lagged associations between predictors at age t and NSSI onset at age t + 1 are set to equality across all assessment waves. Bottom figure shows a non-proportional model, in which each time-lagged association is estimated independently, and can vary over time

Fig. 2

Path diagram of proportional discrete-time survival model of NSSI onset and both parent and peer relationship factors. Coefficients a, b, c, and d represent the significant proportional effects from the final omnibus model (see Table 5 for additional information). Paths displayed using dotted grey arrows were not statistically significant