TY - JOUR PY - 2024// TI - Joint trajectories of depression and rumination: experiential predictors and risk of nonsuicidal self-injury JO - Journal of the American Academy of Child and Adolescent Psychiatry A1 - Zhu, Jianjun A1 - Zhang, Wei A1 - Chen, Yuanyuan A1 - Teicher, Martin H. SP - ePub EP - ePub VL - ePub IS - ePub N2 - OBJECTIVE: Nonsuicidal self-injury (NSSI) is common in adolescence. Rumination is a key risk factor and often co-occurs with depressive symptoms. This is the first study to examine the joint longitudinal trajectories of rumination and depressive symptoms as predictors of NSSI, and the adverse experiences associated with these trajectories.

METHODS: A community sample of 1,835 adolescents (55.9 % male participants, 12.3 ± 0.5 years of age) completed questionnaires to assess adverse childhood experiences, rumination, depressive symptoms, and NSSI. Assessments were made at four times over 18 months.

RESULTS: A parallel process growth mixture model showed that youths with high trajectories of rumination but low trajectories of depression had moderately increased odds of NSSI (2.43-fold, 95% CI 1.53-3.91) compared to adolescents with low trajectories of both rumination and depression. Odds ratios in adolescents with low trajectories of rumination but increasing or high trajectories of depression were similarly elevated, suggesting that high trajectories of rumination or depression were risk factors in isolation. However, odds were 10.06-fold greater (95% CI 5.68-18.02) when high trajectories of rumination occurred in tandem with high trajectories of depression. Multinomial logistic regression showed that male sex (OR 10.54, 95% CI 5.66-19.63), peer victimization (OR 2.25, 95% CI 1.72-2.96), and parental alienation (OR 1.94, 95% CI 1.46-2.57) were key determinants of membership in the highest risk group.

CONCLUSIONS: Risk for NSSI is markedly increased in adolescents with high longitudinal trajectories of depression and rumination. Reducing exposure to peer victimization, cyber victimization, emotional abuse, parental alienation, and interparental conflict may reduce risk.

Language: en

LA - en SN - 0890-8567 UR - http://dx.doi.org/10.1016/j.jaac.2024.01.014 ID - ref1 ER -