| 【Abstract】 Background Non-suicidal self-harm (NSSI) behavior has become a global public health problem. The detection rate of NSSI behavior among college students in China ranges from 9.8% to 13.53%. The integrated theoretical model indicates that remote family risk factors influence NSSI behavior through the emotion regulation mechanism. However, most existing studies focus on the risk of a single family, and the relationship between cumulative family risk and NSSI behavior and its action path remain unclear. Objective To explore the influence of cumulative family risks on the NSSI behavior of college students, analyze the chain mediating effect of difficulty in emotion regulation and depression, and test the moderating effect of gender, so as to provide a reference for targeted intervention in NSSI behavior. Methods On March 1, 2024, 518 college students from two universities in Heilongjiang Province were selected using the cluster sampling method. The Chinese version of the Childhood Trauma Questionnaire (CTQ), the Difficulties in Emotion Regulation Scale (DERS), the Patients’ Health Questionnaire Depression Scale-9 item，PHQ-9 (PHQ-9), and the Adolescent Self-Harm Questionnaire were used for assessment. Logistic regression analysis was conducted using SPSS 26.0 to test the influence of each factor of cumulative family risk on the NSSI behavior of college students. The chain mediating effect of emotional regulation difficulty and depression between cumulative family risk and NSSI was tested through Model 6 in the Process 4.1 macro program, and the moderating effect of gender on "cumulative family risk → emotional regulation difficulty" was analyzed using Model 83. Results A total of 475 (91.70%) college students completed the valid questionnaire survey. The results of logistic regression analysis showed that childhood abuse (OR= 2.561, 95% CI: 1.566~2.561), non-intact family (OR= 2.108, 95% CI: 1.102~4.029), and left-behind experience (OR= 2.356, 95% CI: 1.021~5.439) were risk factors for NSSI behavior. Cumulative family risk positively predicted NSSI behavior (β= 0.345, 95% CI: 1.059~4.286, P < 0.01), and indirectly affected NSSI behavior through the chain mediating effect of emotion regulation difficulty (β= 0.136, 95% CI: 0.882~4.681, P < 0.05) and depression (β= 0.160, 95% CI: 0.316~1.073, P < 0.01) (β= 0.081, 95% CI: 0.034~0.324, P < 0.05); gender played a moderating role between cumulative family risk and emotion regulation difficulty (β= 0.103, 95% CI: 1.567~8.316, P< 0.01), and cumulative family risk could predict emotion regulation difficulty in female college students (β= 0.374, 95% CI: 0.099~0.084, P < 0.01).Conclusion Cumulative family risk can directly affect the NSSI behavior of college students, and it can also indirectly influence NSSI behavior through emotional regulation difficulties and depression. The "cumulative family risk → emotional regulation difficulties" path in this mediating model is moderated by gender. |