More than just enduring: Mental health and well-being among Swedish young adults who ceased self-injuring since adolescence

Non-suicidal self-injury (NSSI) includes non-lethal behaviours like cutting or hitting oneself, typically not intended as suicidal. NSSI is associated with adversity and mental health problems, and can be used to manage and endure such distress. While most adolescents who self-injure stop before reaching adulthood, little is known about their current situation and what facilitates NSSI cessation alongside improved health. This dissertation aimed to investigate:

1. The mental health and well-being of Swedish young adults who ceased NSSI since adolescence.
2. The psychosocial conditions facilitating NSSI cessation and psychological growth between adolescence–adulthood.

Data from the longitudinal SoL project was utilized. Participants completed questionnaires in 2007 (T1: N = 992, mean age = 13.73), 2008 (T2: N = 987, mean age = 14.78), and 2017 (T3: N = 557, mean age = 25.33). Additionally, 11 respondents were interviewed in 2018.

Results indicate: (aim 1) Adolescent NSSI is linked to negative life events, depression, anxiety, and stress in adulthood. However, young adults who ceased NSSI reported higher emotional regulation, well-being, and resilience compared to those who continued. (aim 2) Cessation could not be predicted from adolescent psychosocial functioning, but interviews identified agency as crucial in ceasing NSSI in conjunction with improved well-being. Intentionality was ascribed to positive life experiences; accordingly, those who ceased NSSI reported more positive life events 1–5 years prior compared to those who continued.

In conclusion, young adults who ceased NSSI still face distress from past and recent mental health issues and adversity. Initiating and sustaining behavioural change within detrimental contexts is difficult, and ceasing NSSI in such contexts does not equate psychological growth. However, sensing agency and positive experiences can make life meaningful despite ongoing challenges, making life become more than something that needs to be endured.