Associations of coping styles with nonsuicidal self-injury in adolescents: Do they vary with gender and adverse childhood experiences?

Background: The impact of positive coping style on non-suicidal self-injury in adolescents remains unclear, while negative coping style increases the risk of non-suicidal self-injury (NSSI). There is less investigation on gender differences in the impacts of positive coping style and negative coping style on NSSI. It is unknown whether the impacts vary with different levels of adverse childhood experiences (ACEs). Aims: To identify gender differences in the impacts of positive coping style and negative coping style on NSSI, and investigate the impacts at different levels of ACEs. Method: An adolescent health survey was conducted in 15 schools in China between November 2013 and January 2014. 9704 students aged 11-19 years completed standard questionnaires to record the details of coping style, NSSI and ACEs. Results: 38.5 % of adolescents had >= 1 NSSI over the past 12 months. NSSI was significantly increased with the low positive coping style in girls with >= 3 ACEs, but not with 0 and 1-2 ACEs, and not in boys with any levels of ACEs. NSSI was increased with high negative coping style in both girls and boys across all ACEs. The negative coping style impact was stronger in girls than in boys (odds ratio 1.66, p < 0.05), especially in those with 1-2 ACEs. Conclusions: Adolescents at high risk of NSSI in relation to coping styles should be targeted accordingly. Reducing negative coping style in girls and boys and improving positive coping style in girls who have high ACEs could help prevent NSSI in adolescents.