In an era where adolescent mental health has become an ever-pressing concern, new research sheds light on the nuanced and critical relationship between self-injurious behavior (SIB) and the mental health landscape shaped by the COVID-19 pandemic. A groundbreaking study conducted in Greece delves into the complex interplay between emotional distress, behavioral challenges, and trauma stemming from the pandemic, offering valuable insights into how these factors converge to influence self-injury among young people.
Self-injurious behavior, a phenomenon characterized by deliberate harm to oneself without suicidal intent, has long been recognized as a marker for emotional dysregulation and heightened suicide risk during adolescence. Until recently, research predominantly attributed such behavior to interpersonal traumas such as abuse or neglect. The novel contribution of this Greek cohort study lies in its examination of non-interpersonal traumatic experiences—specifically, those tied to COVID-19—and their influence on adolescent SIB.
The study assessed a large, non-clinical sample of 5,612 adolescents aged approximately 13 years, representing a significant cross-section of Greek youth amid the ongoing global health crisis. Utilizing robust psychometric instruments such as the Strengths and Difficulties Questionnaire (SDQ) and the Children’s Revised Impact of Event Scale-8 (CRIES-8), the researchers meticulously quantified emotional symptoms, conduct problems, hyperactivity, peer difficulties, and trauma-related stress.
One of the startling revelations is the high prevalence of SIB in this population, with over a quarter of participants reporting engagement in such behaviors. Suicidal ideation and previous suicide attempts were also notably prevalent, underscoring the gravity of adolescent mental health challenges in the studied cohort. These figures outstrip many previous estimates, signaling a potential escalation linked to pandemic-related stressors.
Importantly, the study’s statistical analyses illuminated key mental health factors strongly associated with SIB. Elevations in emotional symptoms, conduct issues, and peer relationship difficulties significantly increased the odds of self-injury. Conversely, reduced prosocial behaviors—actions intended to benefit others—were linked to greater risk, suggesting that deficits in social connectedness may exacerbate vulnerability.
Beyond these psychological dimensions, the study uniquely isolates the impact of COVID-19–related traumatic experiences. Intrusive symptoms measured through the CRIES-8, reflecting involuntary and distressing memories of the pandemic, showed a modest but statistically significant association with SIB. This finding accentuates how pandemic trauma, even in the absence of direct interpersonal violence, contributes to adolescent psychological distress.
A particularly notable finding identified personal hospitalization due to COVID-19 as a significant predictor of self-injurious behavior. This outcome points to the profound psychological toll that severe, direct encounters with the virus exert on young individuals, potentially triggering trauma responses that manifest through self-injury. It also raises urgent questions about the support structures available to youths recovering from serious illness in the pandemic context.
Gender emerged as a powerful determinant in the risk profile for SIB. Female adolescents were more than twice as likely to engage in self-injury compared to their male counterparts, a trend consistent with global epidemiological patterns. This gender disparity invites further investigation into the social and biological mechanisms underlying differing mental health trajectories during adolescence.
Perhaps most alarmingly, the presence of suicidal ideation and a history of suicide attempts exponentially increased the likelihood of self-injurious behavior. These interrelations highlight the critical importance of suicide risk monitoring alongside self-injury assessments, emphasizing that these phenomena often co-occur and compound risk.
The data collectively underscore the essential need for early detection strategies and targeted interventions aimed at addressing both the emotional dysregulation inherent in adolescent psychopathology and the trauma-specific symptoms triggered by pandemic-related adversity. The results advocate for integrated mental health frameworks that prioritize trauma-informed care to effectively mitigate self-injury and its cascading risks.
This research arrives at a pivotal moment when the mental health consequences of the COVID-19 pandemic are continuing to unfold. By centering on a large, representative sample outside of clinical settings, it offers a comprehensive perspective that could inform public health policies and clinical practices not only in Greece but internationally.
Crucially, these findings challenge mental health professionals and stakeholders to reconsider how non-interpersonal traumas—like those arising from prolonged lockdowns, intensive treatment experiences, and pandemic-induced social isolation—are factored into adolescent mental health assessments. Without such consideration, interventions may fail to identify or adequately address underlying drivers of self-injurious behaviors.
In the broader context of adolescent development, this study illuminates the multifaceted vulnerability of youth navigating an unprecedented global crisis. It brings to the forefront the intersecting roles of emotional instability, social difficulties, trauma exposure, and gender, painting a complex portrait of risk that demands nuanced and multifactorial intervention approaches.
Looking ahead, further research is needed to unravel the causal pathways linking COVID-19 trauma and SIB and to evaluate the long-term outcomes of affected adolescents. Expansion to diverse cultural contexts and the inclusion of longitudinal designs could augment understanding and guide the tailoring of prevention and treatment modalities optimized for pandemic-era challenges.
The study’s implications resonate beyond academic discourse, calling upon educators, clinicians, families, and policymakers to mobilize resources and empathy toward adolescent mental health in transformative ways. By addressing the roots and reverberations of trauma during formative years, society can aspire not only to reduce self-injury but also to foster resilience and well-being in the generations to come.
Ultimately, this investigation serves as a vital testament to the intricate interdependence of mental health difficulties and trauma in shaping adolescent behavior. The evidence compels a paradigm shift—one that integrates trauma sensitivity with mental health promotion—to stem the rising tide of self-injurious conduct intensified by the ongoing shadow of COVID-19.
Subject of Research: Self-injurious behavior in adolescents and its association with mental health problems and COVID-19–related trauma.
Article Title: Self-injurious behavior in Greek adolescents: the role of mental health problems and COVID-19 trauma.
Article References:
Giannakopoulos, G., Zaravinos-Tsakos, F., Pilafa, E. et al. Self-injurious behavior in Greek adolescents: the role of mental health problems and COVID-19 trauma. BMC Psychiatry 25, 579 (2025). https://doi.org/10.1186/s12888-025-07040-7
Image Credits: AI Generated
DOI: https://doi.org/10.1186/s12888-025-07040-7
