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. 2025 Apr 11;25(1):366.
doi: 10.1186/s12888-025-06812-5.

Psychological experiences of parents of adolescent patients with non-suicidal self-injury: a qualitative study based on Bronfenbrenner's ecological systems theory

Ya-Li Hu  1 , Yue Shi  1 , Gui-Zhi Qiao  1 , Yan Sun  2
Affiliations

Psychological experiences of parents of adolescent patients with non-suicidal self-injury: a qualitative study based on Bronfenbrenner's ecological systems theory

Ya-Li Hu et al. BMC Psychiatry. .

Abstract

Background: Non-suicidal self-injury (NSSI)-an increasingly serious mental health issue among adolescents-is closely associated with several mental illnesses. Qualitative studies on parents of adolescents with NSSI behaviors in China-despite some advancements-have neglected to explore it as a result of individual-environment interactions. This qualitative study aimed to investigate the psychological experiences of parents of adolescent patients with NSSI based on Bronfenbrenner's ecological systems theory, thus placing NSSI among adolescents in its corresponding social context.

Methods: This qualitative study was conducted using face-to-face semistructured interviews between April and September 2024. The questions were set based on the Bronfenbrenner's ecological systems theory before the interview. Parents of adolescent inpatients with NSSI were recruited from the mental health department of a tertiary hospital in northern China. Colaizzi's seven-step method was used to organize, analyze, and extract the themes from the data.

Results: Eighteen parents were interviewed. The following four main themes emerged from the interview data: micro-system-coexistence of caregiver distress and growth (persistent negative emotions, positive experiences after self-adjustment, learning about mental illness, and improved disease management capabilities); meso-system-lifestyle changes (forced abandonment of social life, influence on other children, financial burden, and change in family atmosphere); exo-system-weak support system (limited resources of psychiatric services and desire for more supports); and macro-system-cultural environment.

Conclusions: The social ecosystem of parents of adolescents with NSSI is undesirable. Psychological intervention, online and offline extension services, and the dissemination of professional knowledge may help improve the mental health level and care ability of parents of adolescents with NSSI, thereby reducing adolescent self-injurious behaviors.

Keywords: Ecological systems theory; Non-suicidal self-injury; Parents; Psychological experiences; Qualitative study.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All study procedures for human subjects were performed in accordance with the Declaration of Helsinki and received ethical approval from Shanxi Bethune Hospital (approval notice number YXLL- 2024–075). All participants provided written informed consent before participating in the study. The participants were informed that their data were confidential and that they could withdraw from the study at any time. In addition, even if minors are not directly involved, we will ensure that the research process does not potentially harm or influence any minors. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Themes and subthemes on the psychological experiences of parents of adolescent patients with NSSI
See this image and copyright information in PMC

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