Risk Factors For Non-suicidal Self-injury Research Articles

The role of cognitive disengagement syndrome in non-suicidal self-injury among adolescents with attention deficit hyperactivity disorder.

We aimed to investigate the relationship between Cognitive Disengagement Syndrome (CDS) and non-suicidal self injury (NSSI) in adolescents with attention deficit hyperactivity disorder (ADHD). A semi-structured psychiatric interview and an NSSI screening questionnaire were conducted. Questionnaires assessing CDS (with daydreamer, sleepy, and slow subdimensions), depression, anxiety, self-esteem, emotion regulation, coping strategies, and loneliness were administered. Among 104 participants (n: 63, 60.6% girls), the combined type of ADHD was the most common (66.3%), and 35 adolescents (27 girls) were in the NSSI+ group. Although only depression and ADHD were found to be predictors of NSSI in ADHD, CDS was associated with many risk factors of NSSI in ADHD: depression, anxiety, emotion dysregulation, low self-esteem, and emotion-oriented coping ways. After controlling for the effects of cognitive problems/inattentiveness, depression, and anxiety, CDS still correlated with low self-esteem and emotion dysregulation. The daydreamer and slow sub-dimensions of CSD differed between NSSI+ and NSSI- groups, while sleepy did not. CDS is associated with several relevant factors, indirectly relating it to self-harm in ADHD. CDS increases the vulnerability to mental health changes that could lead to NSSI in adolescence with ADHD.

Risk factors of non-suicidal self-injury of youth students at different developmental stages during COVID-19 pandemic in Jingzhou China

Risk factors of non-suicidal self-injury of youth students at different developmental stages during COVID-19 pandemic in Jingzhou China

Alexithymia and peer victimisation: interconnected pathways to adolescent non-suicidal self-injury.

The prevalence of non-suicidal self-injury (NSSI) among adolescents underscores the importance of understanding the complex factors that drive this behaviour. Framed within broader constructs of emotional regulation theories, alexithymia and peer victimisation are thought to interact to influence NSSI behaviours. This research addresses whether alexithymia and peer victimisation serve as risk factors for NSSI and, if so, how these factors interact with each other. This quantitative study analysed data from 605 adolescents, using a range of validated self-report measures including the Toronto Alexithymia Scale. Statistical analyses including one-way analysis of variance, multiple regression and structural equation modelling were employed to scrutinise the relationships among the variables. Alexithymia and peer victimisation significantly predicted NSSI behaviours. Specifically, the 'difficulty in identifying feelings' subscale of alexithymia emerged as a noteworthy predictor of NSSI (P < 0.001). Peer victimisation mediated the relationship between alexithymia and NSSI, explaining approximately 24.50% of alexithymia's total effect on NSSI. In addition, age was a significant predictor of NSSI, but gender and education years were not (P > 0.05). These relationships were found to be invariant across genders. This study enriches our understanding of the interplay between alexithymia, peer victimisation and NSSI, particularly within the Chinese context. Its findings have significant implications for a rethinking of alexithymia's theoretical construct and interventions targeting emotional literacy and peer dynamics among adolescents. Future research could benefit from a longitudinal design to establish causality.

Cognitive reactivity as a risk factor for non-suicidal self-injury in young adults

Objectives Non-suicidal self-injury (NSSI) risk in young adults is impacted by both affective and cognitive responses to stress. While previous research shows affective reactivity (AR) increases risk for NSSI, less research has examined the role of cognitive reactivity (CR). The current study examined how individual differences in CR to stress relate to NSSI. Participants The sample included 192 college students (M = 19.84 years, SD = 2.51, 82% women). Methods Participants completed a baseline questionnaire followed by a laboratory visit involving measures before and after stress induction. Results Analyses indicated that individuals who engage in NSSI reported more affective and cognitive reactivity to stress. Additionally, higher levels of affective and cognitive reactivity uniquely predicted NSSI. A combined model yielded mixed results. Higher levels of AR led to lower levels of CR, while higher levels of CR predicted more NSSI. Conclusion In sum, results demonstrated significant but unique effects of affective and cognitive reactivity to stress on NSSI.

The relationship between depressive mood and non-suicidal self-injury among secondary vocational school students: the moderating role of borderline personality disorder tendencies.

Non-suicidal self-injury (NSSI) has become an important public health issue of global concern, often occurring in adolescents, and depressive mood is closely related to NSSI. In addition, NSSI is considered a symptom of borderline personality disorder. It has been found that adolescents in secondary vocational schools are more vulnerable to behavior and emotional disorders than those in general high schools. This study investigated the risk factors associated with NSSI affecting secondary vocational school students and analyzed the role of borderline personality disorder tendencies in promoting the occurrence of NSSI among students with depressive moods. A total of 1,848 Chinese secondary vocational students completed a self-report questionnaire. The homemade NSSI behavior questionnaire, Patient Health Questionnaire-9 and Personality Diagnostic Questionnaire-4 were used in this survey. Binary logistic regression and PROCESS software analysis were used to explore the influencing factors associated with NSSI and to test for moderating effects. Female (OR = 3.412, 95% CI 2.301-5.060), drinking history (OR = 2.007, 95% CI 1.383-2.911), history of suicidal death exposure (OR = 3.161, 95% CI 1.999-4.999), depressive mood (OR = 2.436, 95% CI 1.668-3.558) and borderline personality disorder tendencies (OR = 2.558, 95% CI = 1.764-3.711) were independent risk factors for NSSI. Borderline personality disorder tendencies (B = 0.047, p = 0.000) moderated the relationship between depressive mood and NSSI. The stronger the borderline personality tendencies, the more NSSI behavior occurred when they were depressive. Borderline personality disorder tendencies in secondary vocational school adolescents significantly enhance the association of depressive mood with NSSI. There is a moderating role for borderline personality disorder tendencies in depressive mood and NSSI.

Does the need for uniqueness lead to non-suicidal self-injury? The mediation of depression and the moderation of gender.

Based on the integrated theoretical model of the development and maintenance of non-suicidal self-injury (NSSI) and gender role theory, this study investigated the longitudinal impact of the need for uniqueness on NSSI among adolescents, and the mediating role of depression and the moderating role of gender. A total of 1,166 middle school students (Mean age = 13.04, SDage = 0.78, range = 11-16) from a city in central China was recruited to complete the Need for Uniqueness Scale, Depression Scale, and Adolescent Self-Injury Questionnaire at two waves. The participants included 475 boys and 457 girls. Convenience sampling was used, and a longitudinal study (2 time points with a 6-month interval) was conducted to test our hypotheses. SPSS 25.0 was used to evaluate reliability, and to calculate descriptive statistics and Pearson correlation. PROCESS version 3 was used to test longitudinal relationships among the need for uniqueness, depression and NSSI, and construct a moderated mediation model. Results revealed that T1 need for uniqueness in adolescents was significantly positively associated with T2 NSSI and T2 depression, and T2 depression was significantly positively associated with T2 NSSI. After controlling for gender, T1 need for uniqueness positively predicted T2 NSSI. Furthermore, the mediation analysis demonstrated that the pathway linking T1 need for uniqueness to T2 NSSI through T2 depression was statistically significant. Moreover, gender moderated the indirect effect from T2 depression to T2 NSSI in the association between T1 need for uniqueness and T2 NSSI. Compared to boys in the same situation, girls who are susceptible to depression were more likely to commit NSSI. This study demonstrated that the need for uniqueness in adolescents longitudinally predicts NSSI through the mediating role of depression and gender moderates the indirect effect from depression to NSSI. The current study not only suggests that the need for uniqueness is a risk factor for NSSI among adolescents, but also provides an empirical basis for the prevention and intervention of NSSI.

An Investigation of the Mediating Roles of Emotion Regulation Difficulties, Distress Tolerance, Self-Compassion, and Self-Disgust in the Association Between Childhood Trauma and Nonsuicidal Self-Injury

Objective Childhood maltreatment has been associated as a risk factor with the development of nonsuicidal self-injury (NSSI), with difficulty in emotion regulation explaining the association. However, little is known about the potential factors that make some individuals with maltreatment history more vulnerable to difficulties in emotion regulation and, in turn, engage in NSSI. The current study aimed to examine the roles of distress tolerance, self-compassion, and self-disgust in the association between childhood maltreatment types and emotion regulation difficulty, which was expected to predict NSSI. Method The sample included 397 university students between the ages of 18 and 30. Participants completed self-report scales assessing childhood maltreatment, emotion regulation difficulty, distress tolerance, self-compassion, self-disgust, and NSSI using the paper-pencil and online methods. The mediation model suggested for the association between childhood maltreatment types and NSSI was tested using path analysis. Results Low distress tolerance, low self-compassion, high self-disgust, and resulting high emotion regulation difficulty mediated the indirect effect of emotional neglect on NSSI. Conclusion The current study sheds light on various factors in the development and maintenance of NSSI and reveals three developmental pathways from emotional neglect in childhood to engaging in NSSI. HIGHLIGHTS Emotional neglect may be a distal risk factor for nonsuicidal self-injury (NSSI). Low distress tolerance and self-compassion and high self-disgust may increase the risk of NSSI. Emotion regulation difficulty may make people engage in NSSI to regulate emotions.

What Is Rejection? Lexical, Experimental, and Analytical Specificity Is Needed to Drive Developmental Psychopathology Research Forward

There is increasing urgency in the quest to identify prospective risk factors for nonsuicidal self-injury (NSSI), driven by a growing teen mental health crisis. NSSI, which involves deliberately harming one’s physical body without suicidal intent, increases rapidly in early to middle adolescence and is a risk factor for suicidality and other mental illness ( 1 Nock M.K. Joiner Jr., T.E. Gordon K.H. Lloyd-Richardson E. Prinstein M.J. Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Res. 2006; 144: 65-72 Crossref PubMed Scopus (1014) Google Scholar ). Accumulating research highlights social (e.g., rejection, poor relationships, low support) and affective (e.g., reactivity, lability, dysregulation) risk mechanisms, among others ( 2 Cipriano A. Cella S. Cotrufo P. Nonsuicidal self-injury: A systematic review. Front Psychol. 2017; 8: 1946 Crossref PubMed Scopus (224) Google Scholar ). However, social and affective risk mechanisms can be linked and may interact to confer risk for NSSI as well as mental illness more broadly ( 3 Hsu D.T. Jarcho J.M. Next up for psychiatry: Rejection sensitivity and the social brain. Neuropsychopharmacology. 2021; 46: 239-240 Crossref Scopus (8) Google Scholar ). This is particularly relevant in adolescence, a time of rapid brain development and increases in both mental health struggles and reliance on peer affiliation ( 4 Guyer A.E. Adolescent psychopathology: The role of brain-based diatheses, sensitivities, and susceptibilities. Child Dev Perspect. 2020; 14: 104-109 Crossref PubMed Scopus (19) Google Scholar ). Despite the recognition that social difficulties are a common correlate of mental illness, few studies integrate robust measures of real-world peer experience within a neuroscience framework to prospectively predict the emergence of adolescent mental health struggles. Understanding whether neural diatheses confer increased vulnerability to specific stressful peer experiences in adolescence is a critical open question—interventions designed to target neural diatheses or to promote specific types of peer experiences may be critical for prevention efforts in the future ( 4 Guyer A.E. Adolescent psychopathology: The role of brain-based diatheses, sensitivities, and susceptibilities. Child Dev Perspect. 2020; 14: 104-109 Crossref PubMed Scopus (19) Google Scholar ). SEE CORRESPONDING ARTICLE ON PAGE 40 SEE CORRESPONDING ARTICLE ON PAGE 40 Neural Reactivity to Social Punishment Predicts Future Engagement in Nonsuicidal Self-injury Among Peer-Rejected AdolescentsBiological PsychiatryVol. 94Issue 1PreviewRates of nonsuicidal self-injury (NSSI) increase dramatically in adolescence. Affective reactivity and adverse social experiences have been linked to NSSI, but less is known about whether these factors may separately or interactively predict NSSI, especially longitudinally. This study combined functional magnetic resonance imaging and a sociometric measure to test whether a combination of neural (e.g., amygdala) reactivity to social punishment and peer-nominated peer acceptance/rejection predicts NSSI longitudinally in adolescence. Full-Text PDF

A cross-sectional study of non-suicidal self-injury in a Chinese adolescent inpatient cohort.

Non-suicidal self-injury (NSSI) is a significant predictor of completed suicide and is increasingly recognized as a serious public health concern. Multiple factors, including social, familial, mental, and genetic factors could influence the occurrence of this behavior. Identifying the early risk factors is important for screening and preventing this behavior. Here, we recruited a total of 742 adolescent inpatient participants from a mental health center and conducted a series of diagnostic interviews and questionnaires to assess NSSI behavior and other events. Bivariate analysis was used to detect differences between groups in NSSI and non-NSSI. Then, binary logistic regression was fitted to identify predictors of NSSI as a function of these questionnaire scores. Of the 742 adolescents examined, a total of 382 (51.5%) participants engaged in NSSI. Bivariate analysis showed that age, gender, depression, anxiety, insomnia, and childhood trauma was significantly associated with NSSI. Logistic regression results suggested that females had 2.43 higher odds of engaging in NSSI when compared to their male counterparts (OR = 3.43, 95%CI = 2.09-5.74, p = 1.70 × 10-6). Depression was a primary risk predictor for NSSI with each additional increase in symptoms of depression increasing the odds of engaging in NSSI by 18% (OR = 1.18, 95%CI = 1.12-1.25, p = 2.25 × 10-8). More than half of the adolescent inpatients with psychiatric disorders have NSSI experience. Depression and gender were the risk factors for NSSI. Age at a specific range had a high prevalence of NSSI.

Non-suicidal self-injury in a college sample: Intrapersonal and family factors

Objective: Adolescents and young adults are at risk for non-suicidal self-injury (NSSI) and suicidal behavior. This study examined intrapersonal (depressive symptoms, self-criticism) and family (perceived family functioning, parenting style, parental attachment) factors associated with reported history of NSSI in a college sample. Method: Participants included 111 undergraduate students (Mage = 20.2) from a private, nonprofit university. Data were collected via online survey. Hierarchical logistic regression analysis was conducted. Results: The final model was statically significant, Nagelkerke R 2 = .40, suggesting a robust association between the predictors and history of NSSI. Self-criticism and unhealthy family functioning were significant predictors of NSSI behaviors after controlling for study variables and demographic characteristics. Reported history of engaging in NSSI was positively correlated with parent alienation, unhealthy family functioning, self-criticizing behaviors, and depressive symptoms. Conclusion: College mental health providers should be familiar with risk factors of NSSI as well as strategies to address self-criticism.

Cybervictimization and nonsuicidal self-injury: The mediating role of depressive symptoms and the moderating role of emotional reactivity.

Nonsuicidal self-injury (NSSI) has garnered growing attention in recent years, and cybervictimization (CV) has been identified as a risk factor for NSSI among adolescents. However, little is known about this association's longitudinal mediating and moderating mechanisms. Guided by the experiential avoidance model, the present study used a short longitudinal design to examine the mediating role of depressive symptoms and the moderating role of emotional reactivity between CV and NSSI. A total of 577 Chinese middle school students (Mage = 14.38, SD = 0.67) completed the measures of CV, NSSI, depressive symptoms, and emotional reactivity. They provided data in two waves (T1 and T2, 6 months apart). The results found a longitudinal association between CV and NSSI as well as the mediating role of depressive symptoms. Moreover, emotional reactivity amplified the relationship between CV and NSSI via depressive symptoms; specifically, the relationship between depressive symptoms and NSSI was only significant for adolescents with high emotional reactivity. The current study has found that emotional reactivity moderated the indirect effect of depressive symptoms on the relationship between CV and NSSI. These findings have implications for the identification and intervention of NSSI in early adolescents.

Development and validation of a prediction nomogram for non-suicidal self-injury in female patients with mood disorder.

Non-suicidal self-injury (NSSI) is a highly prevalent behavioral problem among people with mental disorders that can result in numerous adverse outcomes. The present study aimed to systematically analyze the risk factors associated with NSSI to investigate a predictive model for female patients with mood disorders. A cross-sectional survey among 396 female patients was analyzed. All participants met the mood disorder diagnostic groups (F30-F39) based on the Diseases and Related Health Problems 10th Revision (ICD-10). The Chi-Squared Test, t-test, and the Wilcoxon Rank-Sum Test were used to assess the differences of demographic information and clinical characteristics between the two groups. Logistic LASSO Regression Analyses was then used to identify the risk factors of NSSI. A nomogram was further used to construct a prediction model. After LASSO regression selection, 6 variables remained significant predictors of NSSI. Psychotic symptom at first-episode (β = 0.59) and social dysfunction (β = 1.06) increased the risk of NSSI. Meanwhile, stable marital status (β = -0.48), later age of onset (β = -0.01), no depression at onset (β = -1.13), and timely hospitalizations (β = -0.10) can decrease the risk of NSSI. The C-index of the nomogram was 0.73 in the internal bootstrap validation sets, indicated that the nomogram had a good consistency. Our findings suggest that the demographic information and clinical characteristics of NSSI can be used in a nomogram to predict the risk of NSSI in Chinese female patients with mood disorders.

Interpersonal stress and nonsuicidal self-injury disorder in veterans: An ecological momentary assessment study.

Nonsuicidal self-injury (NSSI) is associated with marked functional impairment and is a robust predictor of suicide attempts. Prevalence rates of NSSI, and self-directed violence more broadly, are elevated among military veterans. Despite the inclusion of interpersonal difficulty in the diagnostic criteria for NSSI disorder, the relationship between interpersonal risk factors and NSSI is not well-characterized, especially among veterans. This ecological momentary assessment (EMA) study investigated the hypothesis that interpersonal stressors and associated distress would precede and predict NSSI urge and engagement-but not vice versa-via cross-lagged multilevel modeling. Forty veterans with NSSI disorder completed a 28-day EMA protocol with three daily prompts assessing NSSI urges, NSSI engagement, the occurrence of interpersonal stressors, and associated subjective interpersonal distress. Interpersonal stressors preceded and predicted subsequent NSSI urges, but not NSSI engagement, whereas subjective interpersonal distress preceded and predicted both NSSI urges and NSSI engagement. Results identified interpersonal stressors as a risk factor for NSSI urges, and interpersonal distress as a risk factor for both NSSI urges and NSSI engagement. Findings highlight the importance of temporally assessing interpersonal factors related to NSSI and suggest that interpersonal distress may be a modifiable risk factor for NSSI.

Associations Between Family Function and Non-suicidal Self-injury Among Chinese Urban Adolescents with and Without Parental Migration.

The study aims to explore the effect of family function on non-suicidal self-injury (NSSI) among Chinese urban adolescents with and without parental migration. Between April 21st to May 12th, 2021, adolescents were recruited from Shenzhen city of Guangdong province, China (n = 124,357). Of all the participants, 22,855 (18.4%) were left-behind children (LBC). Family function, NSSI, depression, and socio-demographic characteristics were assessed using a series of self-reported questionnaires. Urban LBC had a higher NSSI frequency, while a lower level of family function than non-LBC. After controlling for confounders, parental migration was significantly associated with NSSI, and family dysfunction was a robust risk factor for NSSI as well. The protective effect of family function on NSSI of LBC was stronger than non-LBC. This implies that children with higher levels of family function tend to exhibit a lower frequency of NSSI, especially in those with parental migration. In practice, adolescents' NSSI prevention and intervention strategies should focus on improving family function.

Adverse childhood experiences as a risk factor for non-suicidal self-injury and suicide attempts in forensic psychiatric patients

BackgroundExposure to adverse childhood experiences (ACE) have been found to have profound negative consequences on an individuals’ health. Non-suicidal self-injury (NSSI) is a clinically complex and serious global health issue and is closely related to suicide attempts. Previous research has found associations between ACE and NSSI and suicide attempts in clinical samples. However, this association has to our knowledge not been studied to this extent in a sample of forensic psychiatric patients. The aim of this study was therefore to describe the prevalence of adverse childhood experiences (ACE) and their associations with non-suicidal self-injury (NSSI) and/or suicide attempts in forensic psychiatric patients.MethodsThe current study is a cross-sectional study of a consecutive cohort of 98 forensic psychiatric patients (86.7% male) in Sweden. We invited 184 patients with a predicted stay of > 8 weeks who had been cleared for participation by their treating psychiatrist. Of these, 83 declined and 98 eligible patients provided informed consent. Information on ACE, NSSI, and suicide attempts derived from files, self-reports (Childhood Trauma Questionnaire-Short Form; CTQ-SF), and interviews were compared separately among participants with and without NSSI or suicide attempts using t-tests. The dose–response association between ACE and NSSI/suicide attempts was analysed using binary logistic regression.ResultsIn file reviews, 57.2% of participants reported physical abuse, 20% sexual abuse, and 43% repeated bullying by peers during childhood. NSSI and suicide attempts were associated significantly with CTQ-SF total scores, with medium effect sizes (d = .60 to .63, p < .01), and strongly with several CTQ-SF subscales. Parental substance abuse was also associated with NSSI (p = .006, OR = 3.23; 95% confidence interval [CI] = 1.36 to 7.66) and suicide attempts (p = .018, OR = 2.75; 95% CI = 1.18 to 6.42). Each additional ACE factor predicted an increased probability of NSSI (p = .016, OR = 1.29; CI = 1.04 to 1.59) but not of suicide attempts. When anxiety and depressive disorders were included in the model, ACE remained a significant predictor of NSSI.ConclusionsWe report extensive ACE, from both files and self-reports. When comparing groups, correlations were found between ACE and NSSI, and ACE and suicide attempts among forensic psychiatric patients. ACE seem to predict NSSI but not suicide attempts in this group, even when controlling for affective and anxiety disorders. Early ACE among forensic psychiatric patients, especially physical and emotional abuse and parental substance abuse, have important impacts on self-harming behaviours that must be acknowledged both by the institutions that meet them as children and in their later assessment and treatment.

Risk factors and protective factors for nonsuicidal self-injury in adolescents: A hospital- and school-based case-control study.

Nonsuicidal Self-Injury (NSSI) in China has increasingly interested clinicians, although few studies have investigated its risk and protective factors. This study examined the risk factors of NSSI among Chinese adolescents. The researchers recruited adolescent participants with NSSI from a hospital outpatient clinic to form a case group and recruited adolescents without NSSI who provided informed consent from the school to form a control group. Participants completed a questionnaire, and data were analyzed using logistic regression. A total of 138 cases and 276 controls participated in this study. Binary multivariate logistic regression analysis with adjusting for age and sex showed that domestic violence (OR = 8.615, 95%CI: 3.081-24.091), parental overconcern (OR = 6.995, 95%CI: 3.447-14.192), guilt (OR = 4.949, 95%CI: 2.227-10.996), and school bullying (OR = 21.676, 95%CI: 6.799-69.109) increased the risk of NSSI, while peer support (OR = 0.068, 95%CI: 0.030-0.150) and living in an urban environment (OR = 0.157, 95%CI: 0.056-0.437) decreased the risk of NSSI. Some psychosocial factors were confirmed to be independent risk and protective factors for NSSI in this study. However, the clinical significance of the results needs to be interpreted with caution due to sample size limitations.

Sleep problems mediate the influence of childhood emotional maltreatment on adolescent non-suicidal self-injury: The moderating effect of rumination

BackgroundNon-suicidal self-injury (NSSI) is a highly serious public health problem among adolescents in China, and childhood emotional maltreatment has been found to be a risk factor for NSSI. ObjectiveLittle is known about the longitudinal association between childhood emotional maltreatment and NSSI as well as its underlying mediating and moderating mechanisms. Thus, we hypothesized whether sleep problems mediated the association between childhood emotional maltreatment and NSSI, and whether this indirect effect was moderated by rumination. Participants and settingA total of 1987 Chinese adolescents (56.1 % males; ages 10 to 14, M = 12.32, SD = 0.53) completed self-report questionnaires regarding childhood emotional maltreatment, sleep problems, rumination non-suicidal self-injury (NSSI) in three waves. MethodsStructural equation model was used to test a moderated mediation model, with gender, age and socioeconomic status and baseline measures as covariates. ResultsChildhood emotional maltreatment was significantly associated with NSSI, and this association was mediated by sleep problems. Moderated mediation analyses revealed that rumination intensified the relation between childhood emotional maltreatment and sleep problems as well as the relation between sleep problems and NSSI. ConclusionsFindings of this study demonstrate a relationship among childhood emotional maltreatment, sleep problems, rumination and NSSI. Interventions that target sleep problems and rumination may be beneficial for reducing NSSI for at-risk adolescents.

Cybervictimization and non-suicidal self-injury among Chinese adolescents: A longitudinal moderated mediation model

BackgroundCybervictimization is a risk factor for nonsuicidal self-injury (NSSI). However, there is a lack of evidence on how and under what conditions cybervictimization may influence NSSI. The present study investigated the mediating effect of self-esteem and the moderating effect of peer attachment on the relationship between cybervictimization and NSSI among Chinese adolescents. MethodsUsing three-wave longitudinal data for one year, a total of 1368 Chinese adolescents (60 % boys; Mage at Wave 1 = 15.05 years, SD = 0.85) completed the measurement using a self-report method. ResultsThe longitudinal moderated mediation model revealed that cybervictimization is associated with NSSI via restraining the protective effect of self-esteem. Moreover, high peer attachment could buffer the negative effects of cybervictimization, and protect their self-esteem from being hurt, consequently reducing the likelihood of NSSI. LimitationsAll variables in this study were self-reported, and the results should be cautiously generalized to other cultures, according to a sample of Chinese adolescents. ConclusionsResults highlight the relation between cybervictimization and NSSI. Recommended intervention and prevention strategies include enhancing the self-esteem of adolescents, breaking the cycle of cybervictimization to NSSI, and providing adolescents with more opportunities to build positive friendships with their peers to buffer the negative effects of cybervictimization.

Prevalence of Adverse Childhood Experiences and Their Associations with Non-Suicidal Self-Injury Among Chinese Adolescents with Depression.

The presence of adverse childhood experiences (ACEs) in adolescents diagnosed with depression has been associated with an extensive range of mental health issues, including non-suicidal self-injury (NSSI). However, there has been a dearth of research into the prevalence of ACEs and their associations with NSSI among depressed adolescent populations in China. This study aimed to investigate the prevalence of different types of ACEs and their associations with NSSI in depressed Chinese adolescents. Utilizing Chi-squared tests, latent class analysis (LCA), and multinomial logistic regression, the prevalence of different types of ACEs and their associations with NSSI were determined in a sample of 562 adolescents with depression. Among depressed adolescents. 92.9% of depressed adolescents reported ACEs, and the prevalence of emotional neglect, physical abuse, caregiver treated violently, and bullying was relatively high. ACEs, including sexual abuse (OR = 5.645), physical abuse (OR = 3.603), emotional neglect (OR = 3.096), emotional abuse (OR = 2.701), caregiver divorce/family separation (OR = 2.5), caregiver treated violently (OR = 2.221), and caregiver substance abuser (OR = 2.117), were associated with increased odds of exposure among depressed adolescents with NSSI. The high ACEs class (19%), the moderate ACEs class (40%), and the low ACEs class (41%) were identified as latent classes. NSSI was more prevalent in the high/moderate ACEs class compared to the low ACEs class, particularly in the high ACEs class. The situation of the prevalence of ACEs among adolescents with depression was unsatisfactory, and certain types of ACEs were associated with NSSI. Eliminating potential risk factors for NSSI requires the early prevention and targeted intervention of ACEs. Moreover, additional large-scale longitudinal studies are necessary to assess the different development trajectories associated with ACEs, such as the relationships between the different development periods of ACEs and NSSI, and to ensure the adoption of evidence-based prevention and intervention strategies.

Child maltreatment exposure and adolescent nonsuicidal self-injury: the mediating roles of difficulty in emotion regulation and depressive symptoms

BackgroundAlthough child maltreatment (CM) experiences are recognized risk factors for nonsuicidal self-injury (NSSI), the mechanisms underlying this relationship remain unclear. The purpose of this study was to examine whether difficulty in emotion regulation (DER) and depressive symptoms mediate the relationship between child maltreatment experiences and NSSI severity, adjusting for demographic variables.MethodsThe participants were 224 adolescent inpatients recruited from a hospital in China (mean age 15.30 years, SD = 1.83; 78.6% females). Study measures included the Clinician-Rated Severity of Nonsuicidal Self-Injury (CRSNSSI), Childhood Trauma Questionnaire (CTQ-SF), Difficulties in Emotion Regulation Scale (DERS), and Patient Health Questionnaire-9 (PHQ-9). The hypothesized chain mediation model was tested using the structural equation model.ResultsA total of 146 (65.18%) adolescents reported engaging in NSSI during the past 12 months, and 103 (45.98%) participants met the DSM-5 diagnostic criteria for NSSI. Emotional neglect (48.1%) and emotional abuse (46.1%) had the highest prevalence, followed by physical neglect (43.1%) and physical abuse (24.1%), whereas sexual abuse (12.5%) was the least prevalent form of CM. Separately, both DER and depressive symptoms significantly mediated the association between CM and NSSI, with DER being the strongest mediator, with an indirect effect of 49.40% (p = 0.014). At the same time, we also proved a potential chain-mediated pathway of DER and depression in the relationship between CM and NSSI.ConclusionChild maltreatment seems to play a role in the aetiology of NSSI. DER and depressive symptoms both have a mediating role in the relationship between CM and NSSI. Importantly, DER seems to be a mediator with a stronger indirect effect compared to depressive symptoms.