Differential Psychological and Social Impact of the COVID-19 Pandemic on Spanish Youth With and Without Non-Suicidal Self-Injury: A Longitudinal Analysis

BACKGROUND: Non-suicidal self-injury (NSSI) in adolescents and young adults is a serious public health concern. The COVID-19 pandemic significantly impacted mental health worldwide. This longitudinal study aimed to investigate the differential impacts of COVID-19 on psychological health, social support, and academic performance among young adults with and without previous history of NSSI. METHODS: From an initial sample of 603 college students, 241 (40%) completed this 2.5-year follow-up study. The first assessment was in January-February/2020 (pre-pandemic) and the second in June-July/2022 (post-pandemic). Participants were grouped based on the pres-ence or absence of NSSI at baseline. Variables assessed included sociodemographic data, academic performance, COVID-19-related experiences, clinical characteristics, and perceived social support. RESULTS: A significant reduction in the prevalence of NSSI behaviors was observed over the follow-up period, decreasing from 35% to 8.7%. The NSSI group endorsed worse academic performance post-pandemic. While they maintained stable clinical severity with no observed worsening, during pandemic period they experienced an improvement in perceived social support. In contrast, the Non-NSSI group experienced a decline in perceived social support during the same period. CONCLUSIONS: Contrary to previous studies, our findings indicate that young adults with NSSI significantly reduced self-harm behaviors after the COVID-19 pandemic. Although their academic performance was negatively affected, their clinical severity and social support did not worsen compared to those without NSSI. Findings indicate that the COVID-19 outbreak did not increase NSSI behaviors or exacerbate psychopathology in individuals with NSSI.