Non-suicidal self-injury (NSSI) constitutes any deliberate physical injury to oneself that is not life-threatening. It is a behaviour that commonly starts during adolescence. Childhood family adversity (CFA) is associated with NSSI, but the risk pathways between CFA and NSSI are unclear.
Now, researchers at the University of Cambridge have assessed four different models that might explain the relationship between CFA and NSSI, in a longitudinal study of 933 14 year olds with no prior history of NSSI. The models included: (1) a “mental illness model”, in which NSSI arises from a mental disorder; (2) a “suboptimal environmental hazards model”, based on family dysfunction; (3) a “proximal environmental mitigation model”, based on the quality of peer and family relationships; and (4) an “attachment model”, in which CFA alone causes NSSI. The participants completed various assessments designed to interrogate each of these models, and ~6% reported new onset NSSI by age 17 years.
New onset NSSI was associated with poor family functioning at age 14, supporting the “suboptimal environmental hazards model”. Poor family functioning at age 14 also positively correlated with diagnosis of a mental illness prior to age 14 years. These data suggest that family functioning and mental illness may mediate the association between CFA and NSSI. The researchers suggest that improving the family environment may reduce the effects of CFA on risk of NSSI.
Cassels, M., van Harmelen, A-L., Neufeld, S., Goodyer, I., Jones, P.B. & Wilkinson, P. (2018), Poor family functioning mediates the link between childhood adversity and adolescent nonsuicidal self-injury. J Child Psychol Psychiatr. doi:10.1111/jcpp.12866
Childhood family adversity: childhood exposure to adversities in the family setting, such as poverty or debt, child abuse, domestic violence, parental illness, parental substance abuse, family separation or parental anti-social behaviour
Poor family functioning: A dysfunctional family environment may include difficulties with communication, parenting skills, or parental distress, and can affect children’s development and transition to adulthood