The present study aimed to investigate the relationship between school bullying victimization and non-suicidal self-injury (NSSI) frequency, taking into consideration the mediating roles of coping strategies and emotional regulation. Participants were 12-18-year-old outpatients and inpatients who met the NSSI and depressive disorder criteria according to the DSM-5. Assessments included the Multidimensional Peer-Victimization Scale, Coping Style Scale for Middle School Students, Emotion Regulation Questionnaire for Children and Adolescents, and the Functional Assessment of Self-Mutilation to examine the bullying victimization, coping strategies, emotion regulation, and NSSI behaviour. Serial multiple mediation effects of coping strategies and emotion regulation between bullying victimization and NSSI frequency were analysed using the SPSS macro PROCESS programme. A total of 2335 participants were included in this study. Bullying victimization significantly predicted NSSI frequency (B=0.191, p<0.001). Both coping strategies and emotion regulation were important mediators in the relationship between bullying victimization and NSSI frequency. Bullying victimization indirectly affected NSSI through two serial mediation pathways: (1) bullying victimization → problem-focused coping → cognitive reappraisal → NSSI frequency, and (2) bullying victimization → emotion-focused coping→ expressive suppression → NSSI frequency. The study revealed a positive association between bullying victimization and the frequency of NSSI among adolescents with depressive disorder. Strategies of coping and emotional regulation significantly mediated the link between bullying victimization and the frequency of NSSI. The findings suggested that supporting adolescents in adopting effective coping and emotional regulation strategies could be a crucial approach to mitigate the impact of bullying victimization on the frequency of NSSI.
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