Did social factors buffer against the effect of adversities on self-harm during the COVID-19 pandemic? A longitudinal analysis of 49,227 UK adults

Paul, E.; Fancourt, D.

Background: Little is known about which factors exacerbate and buffer the impact of 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 minutes, and number of days phoning/video calling for >15 minutes 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 on outcomes. Results: Increases in the quality of social support decreased the likelihood of both outcomes, whilst greater loneliness increased their likelihood. Associations were inconsistent for telephone/video contact and face-to-face contact with outcomes. Social support buffered and loneliness exacerbated the impact of adversity experiences with self-harm behaviours. Other interactions were inconsistent, and some were in the unexpected direction. Conclusions: These findings suggest the importance of the quality of social support, rather than the mere presence of contact, is important for reducing the likelihood of self-harm behaviours in the context of COVID-19 pandemic-related adversity and worry.