Non-suicidal Self-injury In Adolescents Research Articles

Alterations of regional brain activity and corresponding brain circuits in drug-naïve adolescents with nonsuicidal self-injury

Nonsuicidal self-injury (NSSI) is one of the major public health problems endangering adolescents. However, the neural mechanisms of NSSI is still unclear. The purpose of this study was to explore regional brain activity and corresponding brain circuits in drug-naïve adolescents with NSSI using amplitude of low-frequency fluctuations (ALFF) combined with functional connectivity (FC) analysis. Thirty-two drug-naïve adolescents with NSSI (NSSI group) and 29 healthy controls matched for sex, age, and level of education (HC group) were enrolled in this study. ALFF and seed-based FC analyses were used to examine the alterations in regional brain activity and corresponding brain circuits. The correlation between ALFF or FC values of aberrant brain regions and clinical characteristics were detected by Pearson correlation analysis. The NSSI group showed increased ALFF in the left inferior and middle occipital gyri, lingual gyrus, and fusiform gyrus; additionally, decreased ALFF in the right medial cingulate gyrus, left anterior cingulate gyrus, and left medial superior frontal gyrus compared to those in the HC group. With the left inferior occipital gyrus as seed, the NSSI group showed increased FC between the left inferior occipital gyrus and the bilateral superior parietal gyrus, right inferior parietal angular gyrus, right inferior frontal gyrus of the insular region, and left precuneus relative to that the HC group. With the left anterior cingulate gyrus as seed, the NSSI group showed increased FC between the left anterior cingulate gyrus and right dorsolateral superior frontal gyrus. With the left lingual gyrus as seed, the NSSI group showed increased FC between the left lingual gyrus and right middle frontal gyrus, and decreased FC between the left lingual gyrus and the left superior temporal gyrus, right supplementary motor area, and left rolandic operculum. With the left fusiform gyrus as seed, the NSSI group showed increased FC between the left fusiform gyrus and left middle and inferior temporal gyrus, and decreased FC between the left fusiform gyrus and the bilateral postcentral gyrus, right precentral gyrus, right lingual gyrus, and left inferior parietal angular gyrus. Moreover, the FC value between the left fusiform gyrus and left inferior temporal gyrus was positively correlated with suicidal ideations score. This study highlights alterations in regional brain activity and corresponding brain circuits in brain regions related to visual and emotional regulation functions in drug-naïve adolescents with NSSI. These findings may facilitate better understand the underlying neural mechanisms of NSSI in adolescents.

Exploring the effect of family function on non-suicidal self-injury among Chinese adolescents in different family socioeconomic status.

Non-suicidal self-injury (NSSI) among adolescents represents an alarming public health concern worldwide. Both family function and family socioeconomic status (SES) were found to play important roles in adolescent NSSI engagement. However, the effects of family function on NSSI among adolescents in different family SES are not well evidenced. This study aimed to explore how family functions (adaptation, partnership, growth, affection, and resolve) affect NSSI among adolescents in different family SES levels. Data used in this study was derived from the Students' Mental Health Network Project (SMHN), a survey conducted among 8,872 pairs of adolescent-caregivers in a city in central China. Socio-demographic characteristics, family function, NSSI, adverse life events, and depressive symptoms were measured among adolescents. Family SES were generated from caregivers self-reported information using principal component analysis. Chi-square test and multivariate binary logistic regression analyses were adopted to analyze the effects of family function on NSSI. It revealed that 10.2% of adolescents reported engaging in NSSI in the past 12 months. Poor family function and high family SES were positively associated with NSSI. Partnership, both adaptation and affection, resolve were NSSI-protective factors for adolescents in low, middle, high family SES, respectively. Efforts to address NSSI should acknowledge the association between family function and NSSI among adolescents in different family SES levels.

Effects of decision making and impulsivity on the addictive features of non-suicidal self-injury behaviors in adolescents with depressive disorder

BackgroundNon-suicidal self-injury (NSSI) behaviors pose a significant threat to the physical and psychological well-being of adolescents. Recent research suggests that persistent, uncontrollable and repetitive NSSI can be conceptualized as a behavioral addiction. The addictive feature of NSSI behavior can be assessed using Ottawa self-injury inventory (OSI), the higher addiction score indicates the more serious NSSI behavior. This study aims to explore the relationship of impulsivity and decision-making on the addictive features of NSSI in adolescents with depressive disorder, to explore the influencing factors of behavioral addictive features of NSSI and to predict the addictive features of NSSI.MethodsUsing a cross-sectional design, a total of 126 adolescent outpatients and inpatients with a mean age of 15.49 years old (M = 15.49, SD = 1.56), male students (n = 28, 22.2%) and female students (n = 98, 77.8%) diagnosed with depressive disorders were recruited according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and clinical interviews were completed by two psychiatrists. NSSI addictive features according to the OSI’s addictive features items. The final group was categorized into three groups: depression without NSSI (n = 42), depression with NSSI without addictive features (n = 44), and depression with NSSI and addictive features (n = 40). The present study employed the Hamilton Depression Scale (HAMD-24), Chinese Revised Barratt Impulsiveness Scale Version 11 (BIS-11), OSI, and the Adolescent Non-Suicidal Self-Injury Questionnaire (ANSSIQ). Cognitive decision-making abilities were assessed using the Iowa Gambling Task (IGT).ResultsThe depression with NSSI addictive features group had significantly lower total net scores and net scores of block3, block4, and block5 in the IGT than the depression without NSSI group, whereas there was no statistically significant difference between the two in net scores of block1 and block2. Lower scores mean more unfavorable decisions and strategy adjustments. The addictive features of NSSI behaviors were significantly and positively correlated with the severity of NSSI behaviors, depression, and cognitive impulsiveness, and significantly and negatively correlated with the total net score of the IGT. The severity of NSSI behaviors, severity of depression, cognitive impulsiveness positively predicts the addictive features of NSSI behaviors, the total net score of the IGT negatively predicted the addictive features of NSSI behaviors.ConclusionAdolescents with depressive disorders with NSSI behavioral addictive features had higher severity of depression, exhibited higher cognitive impulsivity, and made more unfavorable decisions when making choices.

Impact of mentalization, identity diffusion and psychopathology on nonsuicidal self-injury among adolescents.

Nonsuicidal self-injury (NSSI) has become a major public health issue in adolescents. This cross-sectional case-controlled study aims to assess the impact of identity diffusion, psychopathology, and mentalization on NSSI in adolescence. The study sample consisted of 153 adolescents (76.5% girls; Mage = 15.6 years). The sample included 56 clinical cases of NSSI, 45 psychiatric cases without NSSI, and 52 healthy controls, all recruited in Ankara, Türkiye, from June 1, 2022, to August 31, 2022. Mentalization was assessed by "The Movie for the Assessment of Social Cognition" (MASC) which categorizes mentalizing as "correct mentalizing" "hypermentalizing" "undermentalizing" and "no-mentalizing". All participants filled in the Self-Injurious Behavior Screening Questionnaire, Assessment of Identity Development in Adolescence (AIDA), and Youth Self Report (YSR), and Inventory of Statements About Self-injury (ISAS). The NSSI group showed lower mentalizing capacity than the healthy control group (p = .011), and more no-mentalizing errors than the other two groups (p = .014). Identity diffusion scores were higher in the NSSI group than in the other two groups (p < .001). Multivariate logistic regression analysis showed that the presence of maternal psychiatric disorder (p = .019, OR = 5.21), identity diffusion (p = .007, OR = 1.02), no mentalizing (p = .049, OR = 1.28), and total psychopathology symptoms (p = .009, OR = 1.12) had a significant impact on NSSI. Current findings suggest that transdiagnostic approaches, including mentalization and identity diffusion, may contribute to a more comprehensive understanding of NSSI and to the development of clinical interventions.

Longitudinal relations between non-suicidal self-injury and both depression and anxiety among senior high school adolescents: a cross-lagged panel network analysis.

Comorbidity between non-suicidal self-injury (NSSI) and depression and anxiety was common. In the framework of network theory, the examination of directionality and gender differences in longitudinal relationships at the symptom level made a significant contribution to the understanding of comorbidity. Therefore, this study employed cross-lagged panel network analysis to investigate the longitudinal interrelations between NSSI and depression and anxiety in Chinese adolescents, with a focus on gender differences. The study was conducted with a sample of 884 senior high school students (F/M: 481/403; mean age: 15.19±0.48 years) from Jinchang City, Gansu Province, China. All respondents completed the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire and the two subscales (depression and anxiety) of the Brief Symptom Inventory at two intervals. The data were estimated in R 4.2.0 to construct the cross-lagged panel network (CLPN). The CLPN results uncovered the gender differences. For boys, self-hitting and feeling scared emerged as central symptoms. Cutting predicted subsequent feelings of sadness (β=-0.57), tension (β=-0.52) and indifference (β=-0.49), potentially serving as a bridge connecting NSSI to depression and anxiety. For girls, biting themselves and feeling scared were central symptoms. Carving and skin rubbing predicted subsequent feelings of indifference (β=-0.31, -0.21), bridging NSSI to depression and anxiety. In addition, feeling scared emerged as the key bridge symptom connecting depression and anxiety. The findings showed the gender-specific developmental characteristics of the directional relations between NSSI and depression and anxiety at the symptom level. They provided new insights into the comorbidity of NSSI and depression and anxiety, carrying important implications for the screening and intervention of adolescent NSSI.

A latent profile analysis on adolescents' Non-Suicidal Self-Injury related to intrapersonal and interpersonal factors

Non-suicidal self-injury (NSSI) among adolescents continues to be a significant public health concern worldwide. A recent systematic review and meta-analysis found that the global prevalence of NSSI in adolescents aged 12–18 years was 17.2%, with higher rates reported among females (19.7%) than males (14.8%). This behavior has been linked to several negative outcomes, such as depression, anxiety, substance abuse, and suicidal ideation. The present study aimed to classify adolescents based on intrapersonal and interpersonal factors associated with NSSI proposed in Nock’s (2009) integrated model of NSSI, to identify distinct clusters targeting specific risk factors. This encompassed negative cognition, emotional vulnerability, poor coping skill, peer-victimization, family adaptability, and perceived stress. A total of 881 adolescents aged 11–16 years in South Korea completed self-reported questionnaires on automatic thoughts, depression, emotional regulation, peer victimization, family adaptability and perceived stress. Latent profile analysis (LPA) revealed three distinct classes: “the severe group”, “the moderate group”, “the mild group”. Class 3 (“severe group”: N = 127) exhibited greater severity related to NSSI, including negative cognition, emotional vulnerability, poor coping skills, peer victimization, and perceived stress, with weaker levels of factors that can prevent NSSI compared to class 1 (“mild group”: N = 416) and class 2 (“moderated group”: N = 338). The present study emphasizes the importance of considering both intrapersonal (e.g., negative automatic thoughts & emotional dysregulation) and interpersonal factors (i.e., peer victimization) when understanding NSSI - among adolescents. These findings can be utilized to develop interventions aimed at reducing the prevalence and severity of NSSI among adolescents.

Unveiling the hidden connections: network analysis of depressive symptoms, internet addiction, and attachment in Chinese children and adolescents

BackgroundChildren and adolescents diagnosed with major depressive disorder (MDD) often grapple with significant non-suicidal self-injury (NSSI), linked to interpersonal challenges, insecure attachment, and internet addiction. This study explores these relationships in children and adolescents using network analysis, drawing data from seven hospitals in China.ResultsThe study included 162 youths with depressive disorder and 102 healthy controls from seven hospitals. The MDD + NSSI group exhibited severe internet addiction, heightened depressive symptoms, and insecure attachment. Network analysis identified central symptoms (compulsive use) and key bridge symptoms (tolerance symptoms) in the networks related to depressive symptoms, internet addiction, and attachments. These findings suggest potential targets for intervention among children and adolescents at risk for or suffering from depression.ConclusionsThis study sheds light on the intricate relationship between NSSI, attachment issues, and internet addiction in Chinese adolescents with MDD. The network analysis pinpointed central and key bridge symptoms, offering valuable insights for targeted interventions in children and adolescents at risk for or experiencing depression and associated challenges.

Effect of Parenting Style, attachment to parents and self-compassion on the occurrence and recovery motivation for non-suicidal self-injury in adolescents.

Non-suicidal self-injury (NSSI) is a worldwide mental health problem that deserves thorough investigation. This study aims to explore the effect of parenting styles, attachment to parents, and self-compassion on the occurrence of non-suicidal self-injury (NSSI) behavior in adolescents and whether these factors influence their recovery motivation. A total of 132 adolescents who had engaged in NSSI within the last year and 72 adolescents who had never engaged in NSSI were recruited from the Shenzhen Kangning Hospital and from primary and secondary schools and communities. Differences in the Hamilton Depression Scale (HAMD), Inventory of Parent and Peer Attachment (IPPA), Egma Minn av. Bardndosnauppforstran (EMBU), and Self-Compassion Scale (SCS) of participants were compared. A binary logistic model was established to measure the odds ratios of these variables on the occurrence of NSSI. In the NSSI adolescent sample, separate binary logistic models were created with NSSI impulse inhibition, NSSI resistance activity, and NSSI recovery motivation as dependent variables and with parenting styles, attachment to parents, and self-compassion as independent variables. Compared with adolescents with no NSSI behavior, those who had engaged in NSSI within the past year had higher scores on the HAMD, as well as higher EMBU-negative father parental behavior (punishment, excessive interference, rejection, and overprotection), EMBU-negative mother parental behavior (excessive interference, rejection, and punishment), and SCS negative self-compassion scores. Moreover, adolescents with NSSI had lower EMBU-father emotional warmth, EMBU-mother emotional warmth, IPPA-attachment to father, IPPA-attachment to mother, and SCS positive self-compassion scores. Current depressive symptoms and maternal punishment are risk factors for NSSI in adolescents, while positive self-compassion was a protective factor. Positive self-compassion can positively predict NSSI impulse inhibition, NSSI resistance activity, and NSSI recovery motivation. However, we unexpectedly found that the father's emotional warmth negatively predicts NSSI resistance activity. This study found that positive self-compassion has a significant impact on the prevention of and recovery from NSSI behavior in adolescents.

The association between child maltreatment, cognitive reappraisal, negative coping styles, and non-suicidal self-injury in adolescents with major depressive disorder

BackgroundNon-suicidal self-injury (NSSI) is a significant public health concern among adolescents with major depressive disorders (MDD). Although previous research has linked child maltreatment (CM) to NSSI, the precise mechanisms remain unclear. This study aims to investigate the association between CM, cognitive reappraisal (CR), negative coping styles (NC) and NSSI in adolescents with MDD, from the perspectives of both Latent Variable Theory and the Network Theory of Mental Disorder.MethodsA sample of 651 adolescents with MDD was recruited from January to December 2023. Data on CM, CR, NC, and NSSI were collected through paper-based self-reported questionnaires. Data analysis primarily involved structural equation modeling and network analysis.ResultsThe reporting rate of NSSI among adolescents with MDD was 48.2%. CM showed a significant positive correlation with NSSI. NSSI was affected by CM through three paths: the mediating role of CR, the mediating role of NC, and the chain mediating role of both CR and NC. Emotional abuse (EA) was the central node, while NSSI, EA, and “The urge to cry quietly when faced with troubles“(NC10) were the key bridge nodes.ConclusionsThis study is the first to use both structural equation modeling and network analysis to explore the explore the relationship between CM, CR, NC, and NSSI in adolescents with MDD, providing a theoretical basis for future early prevention and targeted interventions for adolescents with MDD.

A multi-modal assessment of self-knowledge in adolescents with non-suicidal self-injury: a research domains criteria (RDoC) study.

Adolescence is a critical period for brain development, consolidation of self-understanding, and onset of non-suicidal self-injury (NSSI). This study evaluated the RDoC (Research Domain Criteria) sub-construct of Self-Knowledge in relation to adolescent NSSI using multiple units of analysis. One hundred and sixty-four adolescents assigned female at birth (AFAB), ages 12-16 years with and without a history of NSSI entered a study involving clinical assessment and magnetic resonance imaging (MRI), including structural, resting-state functional MRI (fMRI), and fMRI during a self-evaluation task. For imaging analyses, we used an a priori defined Self Network (anterior cingulate, orbitofrontal, and posterior cingulate cortices; precuneus). We first examined interrelationships among multi-level Self variables. We then evaluated the individual relationships between NSSI severity and multi-level Self variables (self-report, behavior, multi-modal brain Self Network measures), then conducted model testing and multiple regression to test how Self variables (together) predicted NSSI severity. Cross-correlations revealed key links between self-reported global self-worth and self-evaluation task behavior. Individually, greater NSSI severity correlated with lower global self-worth, more frequent and faster negative self-evaluations, lower anterior Self Network activation during self-evaluation, and lower anterior and posterior Self Network resting-state connectivity. Multiple regression analysis revealed the model including multi-level Self variables explained NSSI better than a covariate-only model; the strongest predictive variables included self-worth, self-evaluation task behavior, and resting-state connectivity. Disruptions in Self-Knowledge across multiple levels of analysis relate to NSSI in adolescents. Findings suggest potential neurobiological treatment targets, potentially enhancing neuroplasticity in Self systems to facilitate greater flexibility (more frequently positive) of self-views in AFAB adolescents.

Predicting non-suicidal self-injury among Chinese adolescents: The application of ten algorithms of machine learning

Background and aimsHigh non-suicidal self-injury (NSSI) prevalence among adolescents is a global health issue. However, current prediction models for adolescent NSSI rely on a limited set of algorithms, resulting in biased predictions. Therefore, the aim of this study is to develop multiple machine learning models to enhance prediction accuracy and mitigate biases among Chinese adolescents. MethodsA total of 4487 junior and senior high school students in China were recruited. Multiple algorithms were included, such as logistic regression, decision tree, support vector machine, Naive Bayes, multi-layer perceptron, K-nearest neighbors, and ensemble learning algorithm like random forest, bagging, AdaBoost, and stacking to build predictive models. Data processing techniques, including standardization and the synthetic minority oversampling technique, were employed to optimize the predictive model. The model was trained on 70 % of the data, reserving 30 % for testing. ResultsThe ten prediction models achieved a good performance, with area under the receiver operating characteristic curve (AUC) scores above 0.700 in the test set. The stacking and random forest models achieved AUC scores of 0.904 and 0.898, respectively. The prediction performance of the Naive Bayes model was relatively poor. The top five important variables were resilience, bully, suicidal ideation, internet addiction, and depression. ConclusionsThe ensemble machine learning algorithm showed promising results predicting NSSI among adolescents. Such algorithms should be recommended for future NSSI research to enhance predictive accuracy. Identification of important features in NSSI prediction can help develop screening protocols and lay a foundation for clinical diagnosis and intervention in adolescent populations.

Longitudinal associations between beta-endorphin, nonsuicidal self-injury and comorbid psychopathology

Homeostasis models posit that nonsuicidal self-injury (NSSI) serves, in part, to upregulate the endogenous opioid system in order to compensate for an opioid deficiency. A few studies have demonstrated lower basal levels of beta-endorphin (BE), an endogenous opioid, in individuals with NSSI. However, longitudinal studies are missing. Hence, the present study aimed to investigate the longitudinal associations between NSSI, comorbid psychopathology (i.e., borderline personality disorder and depressive symptoms), pain sensitivity and basal BE levels in adolescents with NSSI. N = 53 adolescents with NSSI disorder undergoing specialized treatment participated in baseline and one-year follow-up assessments. BE was measured in plasma; pain sensitivity was assessed with a heat pain stimulation paradigm. Associations between BE and change in NSSI, borderline personality disorder and depressive symptoms as well as pain sensitivity were examined using negative binomial and linear regression analyses. We found that an increase in basal BE was significantly associated with a decrease in depressive symptoms. No associations between BE and NSSI, borderline personality disorder symptoms or pain sensitivity were observed. Our findings may confirm a role of plasma BE in the etiology of depressive symptoms but challenge current models of endogenous opioid homeostasis in NSSI.

Social Support and Non-Suicidal Self-Injury in Adolescents: The Differential Influences of Family, Friends, and Teachers.

Non-suicidal self-injury (NSSI) is common among adolescents and is associated with a range of detrimental consequences. Family, teachers, and friends are essential sources of social support for adolescents. Increased social support from these sources may reduce NSSI behaviors among adolescents. However, it is uncertain if each source of social support retains its significance when their influences are evaluated simultaneously, and how each source influences the others to impact NSSI behaviors. To address this gap, this research investigated the direct and indirect effects of each source of social support on adolescent NSSI using cross-lagged panel model (CLPM), as well as whether these relationships varied by sex. A total of 3098 Chinese adolescents with a range of 10 to 15 years old (Mage = 13.27, SD = 0.73, 42.4% girls) completed assessments on three waves across approximately two years. The results indicated that teacher support compared to family and friend support showed the strongest association with NSSI behaviors and mediated the relationship between family support and NSSI. These findings highlight teacher support as a hub in the role of social support on NSSI and emphasize the importance of the connections between teacher and family support.

Which Is The Role of Social Media in Web-Based Adolescent NonSuicidal Self-Injury (NSSI)?

In recent years, there has been a significant surge in non-suicidal self-injury (NSSI)-related content on the Internet. In fact, the technology landscape rapidly evolved, with social media now playing a pivotal role in the lifestyle of the general population, particularly among youths and adolescents. The current review aims at overviewing all studies so far published investigating the relationship between social media and NSSI among adolescents, focusing on the motivations behind posting NSSI-related contents and the role that social media may play in the promotion and/or maintenance of NSSI behaviors. A comprehensive systematic literature review was carried out by using MEDLINE/PubMed. Following screening through established inclusion criteria, eleven studies were finally selected and here retrieved. Due to the high methodological heterogeneity, all studies were assessed and categorized, based on the type of data collection, in three groups: a) studies using direct data (e.g., interviews/surveys); b) indirect data (e.g., content analysis on social media); and, c) mixed data. Major findings reported that social media may significantly influence the development and maintenance of NSSI behaviors. Those victims of cyberbullying often seek out pro-self-harm contents, to both normalize the behavior and/or seek peer-to-peer emotional support. Social media platforms facilitate the dissemination of self-harm techniques and encourage competition among users, exacerbating the severity of self-injury. Interviews highlighted motivations such as attention-seeking, expressing emotions, and feeling part of a group. Other studies showed that social media contents often contain both supportive and harmful advice regarding self-harm. Social media could cover a dual role in both providing support and triggering self-harm through exposure to harmful content(s). Furthermore, social media could also offer opportunities for positive interventions (i.e., awareness campaigns, mental health resources, etc.). Mental health professionals should be aware about the impact of social media on youngsters, as well as providing a routine assessment on social media use in their clinical practice. Future research should explore the (bi)directional causal role of social media on NSSI and viceversa, as well as developing preventive and treatment strategies to support young people to disincentive NSSI behaviors via social media.

Efficacy of Fluoxetine Combined with Cognitive Behavior Therapy in Treating Non-Suicidal Self-Injury in Adolescents: A Systematic Review

Efficacy of Fluoxetine Combined with Cognitive Behavior Therapy in Treating Non-Suicidal Self-Injury in Adolescents: A Systematic Review

Self-disgust mediates the effect of problematic mobile social media use on non-suicidal self-injury in adolescents: A latent growth curve analysis.

Previous research linked problematic mobile social media use to non-suicidal self-injury (NSSI). However, little research explored the underlying mechanism. Drawing on the social displacement hypothesis, which suggests that excessive social media use may disrupt offline social interactions, leading to negative emotional experiences, the study employs a longitudinal design to explore the relationship between problematic mobile social media use and NSSI, with a specific emphasis on the mediating role of self-disgust. A total of 1,684 Chinese adolescents (52.3% females; Mage = 14.59 years, SDage = 1.27) completed self-report questionnaires regarding problematic mobile social media use, self-disgust, and NSSI. The assessment was conducted in three waves, 6 months apart. Using latent growth curve and structural equation modeling, our study observed a consistent linear decline in NSSI levels over time. Higher initial NSSI levels correlated with a slower reduction. Problematic mobile social media use positively influenced the initial level of NSSI. Additionally, self-disgust played a mediating role in the relationship between problematic mobile social media use and NSSI. The study underscores the importance of understanding the emotional experiences behind social media use, beyond mere usage duration. By revealing the mediating role of self-disgust, it provides new insights into the complex interplay between problematic mobile social media use and adolescent NSSI.

Relationship between adolescent internet addiction and adolescent non-suicidal self-injury: a moderated mediation model.

Both Internet addiction (IA) and non-suicidal self-injury (NSSI) are major public health concerns among adolescents, association between internet addiction and non-suicidal self-injury have been observed among adolescents. However, it is unclear how, and under what conditions, internet addiction relates to non-suicidal self-injury. According to our hypothesis, there is a positive relationship between IA and NSSI among Chinese adolescents, but this relationship is affected by the mediating role of loneliness and the moderating role of cognitive reappraisal. A cross-sectional survey was conducted on 1046 Chinese adolescents from 3 middle schools. Measurements: Adolescent Self-Harm Scale; Young's Internet Addiction Test (IAT); University of California at Los Angels (UCLA) Loneliness Scale; Emotional Regulation Questionnaire (ERQ), They were asked to complete self-report questionnaires. In our sample, the detection rate of NSSI was 12.3%. IA was positively associated with NSSI, and loneliness partially mediated the association between them. In addition, cognitive reappraisal moderated the first half path of the mediation model. Specifically, the higher the level of cognitive reappraisal, the weaker the positive effect of IA on NSSI through loneliness. Interventions targeted to reduce loneliness and increase cognitive reappraisal strategies may reduce the risk of NSSI in adolescents with Internet addiction.

A Review of the Influencing Factors and Development Mechanisms of Non-Suicidal Self-Injury in Adolescents

This paper reviews the influencing factors and pathogenesis of adolescent non-suicidal self-injury (NSSI). NSSI is a major public health problem, and its incidence is increasing year by year, especially among adolescents, with the detection rate of NSSI reaching 28.7%. This paper first introduces the epidemiological characteristics of NSSI and points out that there are significant differences in the incidence of NSSI in different countries and regions. Then, this paper analyzes in detail a variety of influencing factors, mainly including environmental factors (childhood trauma, school bullying, social environment, family dysfunction, etc.), individual factors (mental illness, neurobiological differences, personality traits, inadequate Emotion regulation, etc.) and the interaction between individuals and the environment. This paper also discusses the process of NSSI behavior occurrence, maintenance and termination, and introduces several theoretical models such as empirical avoidance model, four-function model and emotional cascade model. Although some progress has been made in existing studies, the occurrence and development mechanism of NSSI behavior is still unclear in existing studies, and longitudinal studies on long-term changes of NSSI behavior are lacking, and research samples are mostly concentrated in specific groups. Future studies should strengthen the longitudinal tracking of NSSI behavior, expand the diversity of research samples, and deeply explore the mechanism and complexity of NSSI, in order to better understand and intervene this important public health problem.

The role of testosterone and cortisol levels in nonsuicidal selfinjury in adolescents.

Nonsuicidal selfinjury (NSSI) is an important problem in adolescence, which is thought to serve several reinforcement functions (positive vs. negative, automatic vs. social). While the psychological mechanisms involved in NSSI are relatively well known, there is an important gap in the knowledge regarding the underlying biological mechanisms. This study examined the role of testosterone (T) and cortisol (C) in the frequency and reinforcement functions of NSSI. A total of 423 adolescents (age range = 13-17; 54.4% girls) from Basque Country (Spain) provided saliva samples to determine T and C levels and completed measures of NSSI 6 months later in 2017-2018. The results showed that T but not C was significantly associated with higher NSSI frequency and the four types of NSSI functions. In addition, C moderated the predictive association between T and NSSI for automatic negative reinforcement, such that this association was significant only when C was high. Participant sex did not moderate any association between hormones and NSSI. These preliminary results suggest that testosterone levels can affect NSSI behaviors in adolescence, thus helping to explain the increase in NSSI during this stage. Moreover, in situations in which NSSI serves to alleviate negative internal states, high levels of cortisol can be involved.

Psychosocial factors affect the occurrence of nonsuicidal self-injury in adolescents with major depressive disorder through chain mediation.

In the adolescent group, about half of adolescents with major depressive disorder (MDD) have NSSI. Psychosocial factors are associated with the development of NSSI. Clarifying the relationship between psychosocial factors and NSSI in adolescents with MDD can help us achieve early prevent. Demographic data, Hamilton Depression Scale-24 (HAMA24), childhood trauma questionnaire, emotional intelligence scale and interpersonal reactivity index were collected from 187 adolescents with MDD. Use ANOVA, Chi-square test, Binary Logistic Regression, Pearson correlation analysis, Mediation effect analysis and the Structural Equation Model for data analysis. The results of ANOVA showed that there was significant difference between the two groups in HAMD24 total score, impulsiveness, emotional intelligence, and empathy (p < 0.05). In the regression analysis, women, depression degree, motor impulsiveness (MI), personal distress (PD) and appraisal of other's emotions empathy were the risk factors for MDD adolescents to produce NSSI behavior. Among the indicators that were significantly related to MDD and NSSI, MI and PD mediate the relationship between MDD and NSSI. The structural equation model showed that MDD, PD and MI had a direct impact on NSSI, but PD and MI had multiple intermediary effected in the relationship between MDD and NSSI. Emotional intelligence, emotional neglect and cognitive impulsiveness indirectly affected the occurrence of NSSI behavior. Impulsiveness, personal distress, emotional neglect, and emotional intelligence are important risk factors that affect NSSI behavior in adolescents with MDD, and they affect the occurrence of NSSI in adolescents with MDD through chain mediation.