The interaction between social factors and adversities on self-harm during the COVID-19 pandemic: longitudinal analysis of 49 227 UK adults

BACKGROUND: Little is known about which factors exacerbate and buffer the impact of coronavirus disease 2019 (COVID-19)-related adversities on changes in thinking about and engaging in self-harm over time. AIMS: To examine how changes in four social factors contribute to changes in self-harm thoughts and behaviours over time and how these factors in turn interact with adversities and worries about adversities to increase risk for these outcomes. METHOD: Data from 49 227 UK adults in the UCL COVID-19 Social Study were analysed across the first 59 weeks of the pandemic. Fixed-effects logistic regressions examined time-varying associations between social support quality, loneliness, number of days of face-to-face contact for >15 min and number of days phoning/video calling for ≥15 min with self-harm thoughts and behaviours. We then examined how these four factors in turn interacted with the total number of adversities and worries about adversity and how this affected outcomes. RESULTS: Increases in the quality of social support were associated with decreases in the likelihood of both outcomes, whereas greater loneliness was associated with an increase in their likelihood. Associations were less clear for telephone/video contact and face-to-face contact with outcomes. Social support buffered and loneliness exacerbated the impact of adversity experiences on self-harm behaviours. CONCLUSIONS: These findings suggest the importance of the quality of one's social support network, rather than the mere presence of contact, for reducing the likelihood of self-harm behaviours in the context of COVID-19 pandemic-related adversity and worry.