Childhood adversity, social support, problematic internet use, psychological vulnerability, and pathways to non-suicidal self-injury and suicidality in adolescents and young adults: a prospective cohort study protocol
Abstract
Background Non-suicidal self-injury (NSSI) and self-harm among adolescents and young adults are increasingly recognised as major public health concerns. Although childhood adversity, family and social support, problematic internet use, psychological vulnerability, and psychiatric symptoms have each been associated with NSSI and suicidality, these factors have often been examined separately. Less is known about how environmental adversity, interpersonal support, and psychological vulnerability interact within an integrated developmental pathway leading to NSSI and suicidality. Methods and analysis Adolescents and young adults aged 13–29 years with a recent history of self-harm or suicidality will be recruited from National Taiwan University Hospital. Community participants without an established psychiatric diagnosis will be recruited from collaborating schools as controls. Participants will complete self-report and caregiver-report measures assessing NSSI, suicidality, childhood adversity, family and social support, problematic internet use, reflective functioning, self-efficacy, impulsivity, and internalising and externalising symptoms. Descriptive and group-comparison analyses will compare psychosocial and clinical characteristics between the clinical and community groups. The primary analysis will use structural equation modelling within the NSSI group to examine whether childhood adverse environment, inadequate family and social support, and problematic internet use are…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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