Evaluation of Psychosocial Risk Factors for Non-Suicidal Self-Injury in Adolescents: A Hospital-Based Cross-Sectional Study
Abstract
Background: Non-suicidal self-injury (NSSI) is an increasingly recognised public health concern among adolescents, yet data from the Indian subcontinent remain limited. As culture strongly shapes self-harm, locally grounded psychosocial information on adolescents who self-injure is valuable. Aim: To evaluate psychosocial risk factors for NSSI in adolescents attending a tertiary psychiatric service. Methods: Sixty adolescents aged 12-18 years with a DSM-5 psychiatric diagnosis and at least one NSSI episode in the preceding year were enrolled by purposive sampling. Sociodemographic and clinical data were collected using a semi-structured proforma and the Functional Assessment of Self-Mutilation (FASM). Analyses used chi-square, Mann-Whitney U and Kruskal-Wallis tests (p < 0.05). Results: Mean age was 14.88 (SD 1.46) years; 53.3% were male, 61.7% rural and 58.3% of low socioeconomic status. Poor emotional regulation affected 81.7% and perceived social media influence 73.3%. Inconsistent discipline (68.3%), a tense emotional atmosphere (56.7%), diffuse boundaries (56.7%) and difficult temperament were each strongly associated with poor emotional regulation (p < 0.0001), and financial stressors affected 63.3%. On the FASM, automatic negative reinforcement was higher in girls (p < 0.001), whereas social negative reinforcement was higher in boys, linked to strained parental relationships (p = 0.030), difficult temperament (p = 0.001) and poor emotional regulation (p = 0.024). Conclusion: Emotional dysregulation, adverse family functioning and interpersonal difficulties were central psychosocial correlates of NSSI. Early identification of at-risk youth and interventions targeting emotion regulation, family functioning and social support are important for prevention. Key words: Non-suicidal self-injury; adolescents; psychosocial risk factors; emotional regulation; family functioning; Functional Assessment of Self-Mutilation.