(PS9-D89) Intersectional Marginalized Identities as Predictors of Time Until First Reported Nonsuicidal Self-injury Among Preadolescent Youth Using Survival Analysis

Objective. National data has revealed significant increases in suicide deaths and nonfatal suicidal behaviors among preadolescent youth over the past decade. Little research, however, has examined nonsuicidal self-injury (NSSI) among preadolescent youth (children under ages 10 and under), largely due to historically low baserates of self-injurious behavior prior to puberty. Stressors related to minoritized identities are associated with higher incidence of NSSI during adolescence, but it is unclear whether this risk extends to children who hold minoritized identities. The present study examines demographic predictors of NSSI onset among a preadolescent youth sample.

Method. Our sample consists of 11,223 youth ages 9 and 10 drawn from the Adolescent Brain and Cognitive Development (ABCD) Study. Demographic information was collected from both participants and their caretakers. Lifetime engagement in NSSI was assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), which was administered annually to adolescents across three waves. Survival models were used to assess overall trends in onset of NSSI across demographic groups.

Results. Participants who endorsed a minoritized sexual orientation (b=5.09, p< .001) or who endorsed questioning their gender identity (b=4.43, p=.002) experienced earlier onset of NSSI behavior compared to heterosexual/cisgender children. Children from minoritized racial/ethnic backgrounds were not, however, at elevated risk for NSSI onset compared to white children (p=.53). A moderation analysis examining intersectional identities indicated an interaction effect such that children who held multiple minoritized identities (e.g., LGBTQIA+ children from minoritized racial/ethnic backgrounds) were at elevated risk for early onset of NSSI compared to both groups of cisgender/heterosexual children (b=0.54, p=.001).

Conclusion. SGM preadolescent youth (including those who are questioning/unsure of their identities) experience an earlier onset of NSSI compared to their cisgender/heterosexual counterparts. Given the moderating effect of SGM status on the relationship between race/ethnicity and NSSI onset, stressors related to sexual orientation and gender identity may be a uniquely powerful driving force in the onset of NSSI among children. Future research should examine specific identity-related stressors, including potentially unique stressors for children who hold intersectional minoritized identities, to better predict and intervene upon self-injurious behavior among children.