Unveiling Interpersonal Dynamics and Childhood Sexual Abuse as Risk Factors for Non-Suicidal Self-Injury among Emerging Adults: A Qualitative Approach

Background: Non-suicidal self-injury (NSSI) represents a significant global mental health issue, impacting not only adolescents but also emerging adults, with substantial repercussions for their psychological, physical, and social well-being. While intrapersonal risk factors, particularly personality traits, have been widely investigated, the influence of interpersonal factors, specifically significant relationships, in predisposing emerging adults to NSSI remains underexplored. Consequently, the current study seeks to examine the role of interpersonal risk factors, with a particular focus on the cultural dynamics that shape interpersonal relationships and contribute to the onset and persistence of NSSI in this population. Methods: This study employed a qualitative design utilizing semi-structured, face-to-face individual interviews to explore the interpersonal factors and traumatic events contributing to non-suicidal self-injury (NSSI). A purposive sampling technique was employed to recruit individuals who met the DSM-5-TR criteria for NSSI. The sample consisted of 10 self-injurers (N=8 females, N=2 males) aged 18 to 29 years, representing the emerging adult population. Semi-structured interviews were conducted with the participants, and the data were analyzed using Interpretative Phenomenological Analysis (IPA). Results: The results of the IPA identified three superordinate themes that reflect the interpersonal risk factors for non-suicidal self-injury (NSSI). These themes are: "Childhood Sexual Abuse," "Dysfunctional Family Dynamics," and "Interpersonal Conflict." These findings highlight the significant role of parenting, family structure, relationships with parents and siblings, and experiences of pre-marital relationships in precipitating episodes of NSSI. Additionally, the experience of childhood sexual abuse by a close family member emerged as a particularly significant etiological factor, especially among female participants. Conclusion: The findings of this study underscore the critical role of cultural influences in shaping interpersonal relationships with family, friends, and partners, which are pivotal in the development of non-suicidal self-injury (NSSI) among emerging adults. The identified interpersonal risk factors emphasize the importance of understanding family dynamics and early parent-child relationships in addressing the underlying causes of NSSI. These insights can assist clinicians in tailoring treatment plans that are more effective and individualized for those engaging in NSSI.