Co-constructing meaning within the family system: a longitudinal dyadic interpretative phenomenological study of adolescents with depression and non-suicidal self-injury and their primary caregivers

作者：Shihan Fang, Yanbo Wang, Yanbo Wang, Xiaoying Zhu, Xiaoyu Huang, Kaitao Yu, Ruobing Qi, Linli Wang, PU Rao, Yating Wang, Yating Wang · 发表于：BMC Psychology · 年份：2026 · DOI：10.1186/s40359-026-04757-2 · 研究领域：Suicide and Self-Harm Studies、Health, psychology, and well-being、Family Caregiving in Mental Illness

BACKGROUND: Adolescent depression accompanied by non-suicidal self-injury (NSSI) is commonly recognized, addressed, and continuously reshaped within the family context. Existing studies predominantly focus on risk factors or caregiver burden, with limited attention to how family members jointly construct and renegotiate meanings of illness, self-injury, and safety over time. This study aimed to explore the interactional experiences of adolescents with depression and NSSI and their primary caregivers across illness stages, and to examine how psychological meanings and relational regulation processes are co-constructed within the family system. METHODS: A longitudinal dyadic interpretative phenomenological analysis was conducted. Ten adolescent-caregiver dyads (N = 20) were interviewed during hospitalization (T1) and at 1 month (T2), 3 months (T3), and 6 months (T4) post-discharge, with optional joint interviews at T3-T4. Analyses followed an idiographic-to-dyadic and cross-temporal trajectory approach, attending to psychological convergence, divergence, and critical turning points across time. RESULTS: A temporal trajectory of family meaning co-construction was identified. During hospitalization (T1), family interactions were often reorganized around risk containment, with NSSI-related distress commonly treated by caregivers as requiring immediate safety-oriented responses. In the post-discharge middle phase (T2-T3), some families entered a seemingly "quiet period," which emer...