Li Juexi,Li Liyuan,Guo Yuxuan,Xiao Xiaoqiang,Tang Peiqi,Pu Ting,Zuo Haixi,Yang Ting,Fan Xiaoxia,Zhou Bo,Adolescent anxiety and non-suicidal self-injury behavior： the mediating role of depression and the moderating role of social support[J].SICHUAN MENTAL HEALTH,2025,(4):357-363

Adolescent anxiety and non-suicidal self-injury behavior： the mediating role of depression and the moderating role of social support

DOI：10.11886/scjsws20241118007

English keywords:Adolescents Non-suicidal self-injury Anxiety Depression Social support

Fund projects:国家自然科学青年基金项目（项目名称：以思维反刍为核心的青少年抑郁症心理干预疗效个体差异脑机制研究，项目编号：82401812）；四川省卫生健康委员会项目（项目名称：以思维反刍和炎症为中介的童年创伤对青少年抑郁症的影响因素模型研究，项目编号：24LCYJPT18）

Author Name	Affiliation	Postcode
Li Juexi	School of Clinical Medicine， Southwest Medical University， Luzhou 646000， China	646000
Li Liyuan	Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital， Sichuan Center of Mental Health， Chengdu 610072， China	610072
Guo Yuxuan	Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital， Sichuan Center of Mental Health， Chengdu 610072， China	610072
Xiao Xiaoqiang	Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital， Sichuan Center of Mental Health， Chengdu 610072， China	610072
Tang Peiqi	School of Clinical Medicine， Southwest Medical University， Luzhou 646000， China	646000
Pu Ting	School of Clinical Medicine， Southwest Medical University， Luzhou 646000， China	646000
Zuo Haixi	Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital， Sichuan Center of Mental Health， Chengdu 610072， China	610072
Yang Ting	School of Clinical Medicine， Southwest Medical University， Luzhou 646000， China	646000
Fan Xiaoxia	Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital， Sichuan Center of Mental Health， Chengdu 610072， China	610072
Zhou Bo^*	School of Clinical Medicine， Southwest Medical University， Luzhou 646000， China Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital， Sichuan Center of Mental Health， Chengdu 610072， China	610072

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English abstract:

Background Non-suicidal self-injury （NSSI） behavior among adolescents has become a global public health concern. Anxiety and depression are considered key factors influencing NSSI behavior， while social support may play a protective role in alleviating emotional and behavioral issues. However， existing research has primarily focused on the direct impact of individual factors on NSSI behavior， with insufficient exploration of the combined effects of anxiety， depression and social support.Objective To investigate the direct effect of anxiety on NSSI， the mediating role of depression and the moderating role of social support in relationship between anxiety and NSSI behavior， thus to provide references for the prevention and intervention of NSSI behavior among adolescents.Methods In February 2022， a total of 40 820 students in grades 7 to 12 across 10 middle schools in a district of Chengdu were selected as participants， and they were assessed using Generalized Anxiety Disorder Scale-7 item （GAD-7）， Patient's Health Questionnaire Depression Scale-9 item （PHQ-9）， Social Support Scale for Urban Students （SSSUS） and Adolescent Self-Harm Scale （ASHS）. Pearson correlation analysis was conducted to examine the correlations between scale scores among adolescents with NSSI behaviors. Mediation and moderation analyses were performed using Process 3.5 in SPSS， and the significance was tested with bootstrapping. The interaction was visualized by using simple slope analysis.Results Among 34 534 （84.60%） valid respondents， 542 adolescents （1.57%） reported engaging in NSSI behavior. Significant differences in gender， GAD-7 scores， PHQ-9 scores， and SSSUS scores were observed between NSSI behavior group and non-NSSI group （χ2/t=62.889， 71.120， 94.365， -41.464， P<0.01）.Adolesents with NSSI showed positive correlations between GAD-7 scores and both ASHS and PHQ-9 scores （r=0.158， 0.166， P<0.01）. PHQ-9 scores were positively correlated with ASHS scores （r=0.364， P<0.01）， but negatively correlated with SSSUS scores （r=-0.290， P<0.01）. SSSUS scores were negatively correlated with ASHS scores （r=-0.247， P<0.01）. Depression partially mediated the relationship between anxiety and NSSI behavior， with an effect size of 0.544 （95% CI： 0.162~0.944）， accounting for 35.79% of the total effect. Social support moderated the relationship between depression and NSSI bahavior， with an effect value of -0.082 （95% CI： -0.135~-0.029）.Conclusion Anxiety not only directly influences NSSI bahavior among adolescents， also indirectly exacerbates it through depression， while social support mitigates the impact of depression on NSSI behavior. ［Funded by Youth Project of National Natural Science Foundation of China （number， 82401812）； Project of Health Commission of Sichuan Province （number， 24LCYJPT18）］

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