Non-suicidal self-injury (NSSI) is a salient risk factor affecting one’s physical and mental health, and its association with adverse experiences has been widely recognized. However, based on the Dimensional Model of Adversity and Psychopathology, different dimensions of adversity (threat and deprivation) may have different effects on NSSI. Thus, identifying the specific effects of different adverse experiences on NSSI is of great importance for the development of intervention strategies. With a sample of Chinese college students (n = 1,609), this study used latent category analysis to classify threatening and deprivation experiences, and structural equation modeling to examine the mediating roles of psychotic-like experiences and internet addiction between social support and NSSI across the threatening and deprivation dimensions, respectively. Compared to those without adverse experiences, participants with adverse experiences showed lower levels of social support, higher levels of psychotic-like experiences, higher degrees of internet addiction, and higher frequencies of both NSSI thoughts in the past 6 months and 1 year and NSSI behaviors in the past 6 months. Furthermore, adverse experiences were found to modify the effect of social support on NSSI thoughts, as social support was negatively associated with NSSI thoughts by reducing psychotic-like experiences in threatening experience group and deprivation experience group with unstable parent’s marital status; however, the protective effect of social support on NSSI thoughts and behaviors was not significant in deprivation experience group with emotional neglect. Family adverse experiences, especially threat experiences, may be a risk factor directly associated with NSSI and also play an important role in the development of NSSI among emerging adults.
AmeduA. N.DwarikaV.AigbodionV. V. (2025). Addressing students’ traumatic experiences and impact of social supports: Scoping review. European Journal of Trauma & Dissociation, 9(1), 100512. https://doi.org/10.1016/J.EJTD.2025.100512
2.
ArmientoJ.HamzaC. A.StewartS. L.LeschiedA. (2016). Direct and indirect forms of childhood maltreatment and nonsuicidal self-injury among clinically referred children and youth. Journal of Affective Disorders, 200, 212–217. https://doi.org/10.1016/j.jad.2016.04.041
3.
BeardsS.FisherH. L.Gayer-AndersonC.HubbardK.ReininghausU.CraigT. J.DiF. M.MondelliV.ParianteC.DazzanP.MurrayR.MorganC. (2020). Threatening life events and difficulties and psychotic disorder. Schizophrenia Bulletin, 46(4), 814–822. https://doi.org/10.1093/schbul/sbaa005
4.
BersteinD. P.FinkL. (1998). Childhood trauma questionnaire: A retrospective self-report. The Psychological Corporation.
5.
BronfenbrennerU.MorrisP. A. (2007). The bioecological model of human development. In EisenbergN.FabesR. A.SpinradT. L. (Eds.), Handbook of child psychology (pp. 793–828). John Wiley & Sons.
6.
CohenJ. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates. https://doi.org/10.4324/9780203771587
7.
CohenS.WillsT. A. (1985). Stress, social support, and the buffering hypothesis. Journal of Personality and Social Psychology, 98(2), 310. https://doi.org/10.1037/0033-2909.98.2.310
8.
CompasB. E. (1987). Stress and life events during childhood and adolescence. Journal of Consulting and Clinical Psychology, 7(3), 275–302. https://doi.org/10.1016/0272-7358(87)90037-7
EvrenC.KuralS.CakmakD. (2006). Clinical correlates of childhood abuse and neglect in substance dependents. Addictive Behaviors, 31(3), 475–485. https://doi.org/10.1016/j.addbeh.2005.05.030
11.
FelittiV. J.AndaR. F.NordenbergD.WilliamsonD. F.SpitzA. M.EdwardsV.KossM. P.MarksJ. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/s0749-3797(98)00017-8
12.
ForsterM.GrigsbyT. J.GowerA. L.MehusC. J.McMorrisB. J. (2020). The role of social support in the association between childhood adversity and adolescent self-injury and suicide: Findings from a statewide sample of high school students. Journal of Adolescence, 49, 1195–1208. https://doi.org/10.1007/s10964-020-01235-9
13.
GaoY. M.LiuJ. M.LiuX.WangY. M.QiuS. J. (2024). Dimensions of family stress and repetitive nonsuicidal self-injury in adolescence: Examining the interactive effects of impulsivity and emotion dysregulation. Child Abuse & Neglect, 152, 106804. https://doi.org/10.1016/J.CHIABU.2024.106804
14.
GaretyP. A.KuipersE.FowlerD.FreemanD.BebbingtonP. E. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31(2), 189–195. https://doi.org/10.1017/s0033291701003312
15.
HassanA. N.De LucaV. (2015). The effect of lifetime adversities on resistance to antipsychotic treatment in schizophrenia patients. Schizophrenia Research, 161(2–3), 496–500. https://doi.org/10.1016/j.schres.2014.10.048
HodginsD. C.SchopflocherD. P.el-GuebalyN.CaseyD. M.SmithG. J.WilliamsR. J.WoodR. T. (2010). The association between childhood maltreatment and gambling problems in a community sample of adult men and women. Psychology of Addictive Behaviors, 24(3), 548–554. https://doi.org/10.1037/a0019946
18.
HoningsS.DrukkerM.GroenR.van OsJ. (2016). Psychotic experiences and risk of self-injurious behaviour in the general population: A systematic review and meta-analysis. Psychological Medicine, 46(2), 237–251. https://doi.org/10.1017/s0033291715001841
19.
HsiehY.-P.ShenA. C.-T.WeiH.-S.FengJ.-Y.HuangS. C.-Y.HwaH.-L. (2016). Associations between child maltreatment, PTSD, and internet addiction among Taiwanese students. Child Indicators Research, 56, 209–214. https://doi.org/10.1016/j.chb.2015.11.048
20.
HuL.BentlerP. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
JanssenI.KrabbendamL.BakM.HanssenM.VolleberghW.de GraafR.van OsJ. (2004). Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatrica Scandinavica, 109(1), 38–45. https://doi.org/10.1046/j.0001-690x.2003.00217.x
23.
JohnstoneJ. M.CarterJ. D.LutyS. E.MulderR. T.FramptonC. M.JoyceP. R. (2016). Childhood predictors of lifetime suicide attempts and non-suicidal self-injury in depressed adults. New Zealand Journal of Psychiatry, 50(2), 135–144. https://doi.org/10.1177/0004867415585581
24.
KambaliM. Y.AnshuK.KuttyB. M.MuddashettyR. S.LaxmiT. R. (2019). Effect of early maternal separation stress on attention, spatial learning and social interaction behaviour. Ethological Behavior Research, 237, 1993-2010. https://doi.org/10.1007/s00221-019-05567-2
25.
KleimanE. M.LiuR. T. (2013). Social support as a protective factor in suicide: Findings from two nationally representative samples. Journal of Abnormal Psychology, 150(2), 540–545. https://doi.org/10.1016/j.jad.2013.01.033
26.
KokkaI.MourikisI.NicolaidesN. C.DarviriC.ChrousosG. P.Kanaka-GantenbeinC.BacopoulouF. (2021). Exploring the effects of problematic internet use on adolescent sleep: A systematic review. International Journal of Environmental Research and Public Health, 18(2), 760. https://doi.org/10.3390/ijerph18020760
27.
KoyanagiA.StickleyA.HaroJ. M. (2015). Psychotic-like experiences and nonsuicidal self-injury in England: Results from a national survey [Corrected]. PLoS One, 10(12), e0145533. https://doi.org/10.1371/journal.pone.0145533
28.
LaceyR. E.MinnisH. (2020). Practitioner review: Twenty years of research with adverse childhood experience scores—Advantages, disadvantages, and applications to practice. Journal of Child Psychology and Psychiatry, 61(2), 116–130. https://doi.org/10.1111/jcpp.13135
29.
LanzaS. T.TanX.BrayB. C. (2013). Latent class analysis with distal outcomes: A flexible model-based approach. Structural Equation Modeling: A Multidisciplinary Journal, 20(1), 1–26. https://doi.org/10.1080/10705511.2013.742377
30.
LeeJ.-Y.LeeJ.-Y.BanD.KimS.-Y.KimJ.-M.ShinI.-S.YoonJ.-S.KimS.-W.KimS.-W. (2019). Negative life events and problematic internet use as factors associated with psychotic-like experiences in adolescents. Frontiers in Psychiatry, 10, 369. https://doi.org/10.3389/fpsyt.2019.00369
31.
LiuB. L.HaoW.YangD. S.QiS. Q.LuoZ. S. (2006). Development of diagnostic scale for Internet Addiction Disorder. Chinese Journal of Clinical Psychology, 14(3), 227–232. https://doi.org/10.16128/j.cnki.1005-3611.2006.03.003
32.
LiuX.HuangX. J. (2010). Social support and its mechanism for mental health. Psychological Research, 3(1), 3–8. CNKI:SUN:OXLY.0.2010-01-003
33.
ManiglioR. (2011). The role of child sexual abuse in the etiology of suicide and non-suicidal self-injury. Acta Psychiatrica Scandinavica, 124(1), 30–41. https://doi.org/10.1111/j.1600-0447.2010.01612.x
34.
MannaG.FalgaresG.CostanzoG.La SalaM. C.LamisD. A.MussoP. (2022). Cumulative childhood maltreatment and non-suicidal self-injury: The mediating and moderating role of perceived social support in a sample of university students. Journal of Family Violence, 37(4), 657–669. https://doi.org/10.1007/S10896-021-00312-2
35.
MarkW.ToulopoulouT. (2017). Validation of the Chinese version of Community Assessment of Psychic Experiences (CAPE) in an adolescent general population. Asian Journal of Psychiatry, 26, 58–65. https://doi.org/10.1016/j.ajp.2017.01.012
36.
MarsB.HeronJ.CraneC.HawtonK.LewisG.MacleodJ.TillingK.GunnellD. (2014). Clinical and social outcomes of adolescent self-harm: Population-based birth cohort study. British Journal of Psychiatry, 349, g5954. https://doi.org/10.1136/bmj.g5954
37.
MartinJ.BureauJ. F.YurkowskiK.FournierT. R.LafontaineM. F.CloutierP. (2016). Family-based risk factors for non-suicidal self-injury: Considering influences of maltreatment, adverse family-life experiences, and parent-child relational risk. Journal of Adolescence, 49, 170–180. https://doi.org/10.1016/j.adolescence.2016.03.015
38.
MasynK. E. (2013). 25 latent class analysis and finite mixture modeling. The Oxford Handbook of Quantitative Methods, 551–611.
39.
McLaughlinK. A.SheridanM. A.LambertH. K. (2014). Childhood adversity and neural development: Deprivation and threat as distinct dimensions of early experience. Neuroscience & Biobehavioral Reviews, 47, 578–591. https://doi.org/10.1016/j.neubiorev.2014.10.012
40.
McTavishJ. R.MacGregorJ. C. D.WathenC. N.MacMillanH. L. (2016). Children’s exposure to intimate partner violence: An overview. International Review of Psychiatry, 28(5), 504–518. https://doi.org/10.1080/09540261.2016.1205001
41.
MesserJ. M.FremouwW. J. (2008). A critical review of explanatory models for self-mutilating behaviors in adolescents. Clinical Psychology Review, 28(1), 162–178. https://doi.org/10.1016/j.cpr.2007.04.006
42.
MillerA. B.Esposito-SmythersC.LeichtweisR. N. (2015). Role of social support in adolescent suicidal ideation and suicide attempts. Journal of the American Academy of Child & Adolescent Psychiatry, 56(3), 286–292. https://doi.org/10.1016/j.jadohealth.2014.10.265
43.
MillonE. M.AlquezaK. L.KamathR. A.MarshR.PagliaccioD.BlumbergH. P.StewartJ. G.AuerbachR. P. (2022). Non-suicidal self-injurious thoughts and behaviors among adolescent inpatients. Child Psychiatry and Human Development, 55, 48–59. https://doi.org/10.1007/s10578-022-01380-1
44.
MittalV. A.DeanD. J.PelletierA. (2013). Internet addiction, reality substitution, and longitudinal changes in psychotic-like experiences in young adults. Early Intervention in Psychiatry, 7(3), 261–269. https://doi.org/10.1111/
45.
MoeA. M.LlamoccaE.WastlerH. M.SteelesmithD. L.BrockG.BridgeJ. A.FontanellaC. A. (2022). Risk factors for deliberate self-harm and suicide among adolescents and young adults with first-episode psychosis. Schizophrenia Bulletin, 48(2), 414–424. https://doi.org/10.1093/schbul/sbab123
46.
PanP.-Y.YehC.-B. (2018). Internet addiction among adolescents may predict self-harm/suicidal behavior: A prospective study. Journal of Psychiatric and Psychological Sciences, 197, 262–267. https://doi.org/10.1016/j.jpeds.2018.01.046
47.
Pinto PereiraS. M.Stein MerkinS.SeemanT.PowerC. (2019). Understanding associations of early-life adversities with mid-life inflammatory profiles: Evidence from the UK and USA. Brain, Behavior, and Immunity, 78, 143–152. https://doi.org/10.1016/j.bbi.2019.01.016
48.
PlenerP. L.BrunnerR.FegertJ. M.GroschwitzR. C.In-AlbonT.KaessM.KapustaN. D.ReschF.BeckerK. (2016). Treating nonsuicidal self-injury (NSSI) in adolescents: Consensus-based German guidelines. Child and Adolescent Psychiatry and Mental Health, 10, 46. https://doi.org/10.1186/s13034-016-0134-3
49.
PuetzV. B.VidingE.GerinM. I.PingaultJ. B.SethiA.KnodtA. R.RadtkeS. R.BrigidiB. D.HaririA. R.McCroryE. (2020). Investigating patterns of neural response associated with childhood abuse versus childhood neglect. Psychological Medicine, 50(8), 1398–1407. https://doi.org/10.1017/S003329171900134X
50.
ReadJ.PerryB. D.MoskowitzA.ConnollyJ. (2001). The contribution of early traumatic events to schizophrenia in some patients: A traumagenic neurodevelopmental model. Psychiatry, 64(4), 319–345. https://doi.org/10.1521/psyc.64.4.319.18602
51.
RejaänZ.van der ValkI. E.SusanB. (2021). The role of sense of belonging and family structure in adolescent adjustment. Journal of Research on Adolescence, 32(4), 1354–1368. https://doi.org/10.1111/JORA.12694
52.
SaarinenA.KeltikangasJ. L.DobewallH.SormunenE.LehtimäkiT.KähönenM.RaitakariO.HietalaJ. (2023). Childhood family environment predicting psychotic disorders over a 37-year follow-up: A general population cohort study. Schizophrenia Research, 258, 17–19. https://doi.org/10.1016/j.schres.2023.06.008
53.
SheridanM. A.McLaughlinK. A. (2014). Dimensions of early experience and neural development: Deprivation and threat. Trends in Cognitive Sciences, 18(11), 580–585. https://doi.org/10.1016/j.tics.2014.09.001
54.
SmythN.SiriwardhanaC.HotopfM.HatchS. L. (2015). Social networks, social support, and psychiatric symptoms: Social determinants and associations within a multicultural community population. Social Psychiatry and Psychiatric Epidemiology, 50(7), 1111–1120. https://doi.org/10.1007/s00127-014-0943-8
55.
SpauwenJ.KrabbendamL.LiebR.WittchenH. U.van OsJ. (2006). Impact of psychological trauma on the development of psychotic symptoms: Relationship with psychosis proneness. British Journal of Psychiatry, 188, 527–533. https://doi.org/10.1192/bjp.bp.105.011346
56.
StankovićM.NešićM.ČičevićS.ShiZ. J. P. (2021). Association of smartphone use with depression, anxiety, stress, sleep quality, and internet addiction: Empirical evidence from a smartphone application. Journal of Personalized Medicine, 168, 110342. https://doi.org/10.1016/j.paid.2020.110342
SvirkoE.HawtonK. (2007). Self-injurious behavior and eating disorders: The extent and nature of the association. Suicide & Life-Threatening Behavior, 37(4), 409–421. https://doi.org/10.1521/suli.2007.37.4.409
59.
SwannellS. V.MartinG. E.PageA.HaskingP.JohnN. J.St (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis, and meta-regression. Suicide and Life-Threatening Behavior, 44(3), 273–303. https://doi.org/10.1111/sltb.12070
60.
TangJ.MaY.LewisS. P.ChenR.CliffordA.AmmermanB. A.GazimbiM. M.ByrneA.WuY.LuX. J. (2020). Association of internet addiction with nonsuicidal self-injury among adolescents in China. JAMA Network Open, 3(6), e206863. https://doi.org/10.1001/jamanetworkopen.2020.6863
61.
ThomassinK.ShafferA.MaddenA.LondinoD. L. (2016). Specificity of childhood maltreatment and emotion deficit in nonsuicidal self-injury in an inpatient sample of youth. Psychiatry Research, 244, 103–108. https://doi.org/10.1016/j.psychres.2016.07.050
62.
TranN. K.BerkelS. R. V.vanL. M. H.AlinkL. R. A. (2018). Child and Family Factors Associated With Child Maltreatment in Vietnam. Journal of Interpersonal Violence, 36(5–6), NP2931–NP2953. https://doi.org/10.1177/0886260518767914
63.
TrottaA.MurrayR. M.FisherH. L. (2015). The impact of childhood adversity on the persistence of psychotic symptoms: A systematic review and meta-analysis. Psychological Medicine, 45(12), 2481–2498. https://doi.org/10.1017/s0033291715000574
64.
TulliusJ. M.KroonM. L. A. D.AlmansaJ.ReijneveldS. A. (2021). Adolescents’ mental health problems increase after parental divorce, not before, and persist until adulthood: A longitudinal TRAILS study. European Child & Adolescent Psychiatry, 31(6), 1–10. https://doi.org/10.1007/S00787-020-01715-0
65.
VareseF.SmeetsF.DrukkerM.LieverseR.LatasterT.ViechtbauerW.ReadJ.van OsJ.BentallR. P. (2012). Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective-, and cross-sectional cohort studies. Schizophrenia Bulletin, 38(4), 661–671. https://doi.org/10.1093/schbul/sbs050
66.
WanY.ChenR.MaS.McFeetersD.SunY.HaoJ.TaoF. (2019). Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents. The British Journal of Psychiatry, 214(3), 146–152. https://doi.org/10.1192/bjp.2018.263
67.
WangY. J.LiX.NgC. H.XuD. W.HuS.YuanT. F. (2022). Risk factors for non-suicidal self-injury (NSSI)in adolescents: A meta-analysis. EClinicalMedicine, 46, 101350. https://doi.org/10.1016/j.eclinm.2022.101350
68.
WilkK.StarowiczA.SzczecińskaM.BudziszewskaM. (2024). Childhood emotional neglect and its relationship with well-being: Mediation analyses. European Journal of Trauma & Dissociation, 8(3), 100434. https://doi.org/10.1016/j.ejtd.2024.100434
69.
WilkinsonP.KelvinR.RobertsC.DubickaB.GoodyerI. J. (2011). Clinical and psychosocial predictors of suicide attempts and nonsuicidal self-injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT). Journal of the American Academy of Child & Adolescent Psychiatry, 168(5), 495–501. https://doi.org/10.1176/appi.ajp.2010.10050718
70.
WilsonJ. M.WeissA.ShookN. J.DifferencesI. (2020). Mindfulness, self-compassion, and savoring: Factors that explain the relation between perceived social support and well-being. Personality and Individual Differences, 152, 109568. https://doi.org/10.1016/j.paid.2019.109568
71.
WuX. S.ZhangZ. H.ZhaoF.WangW. J.LiY. F.BiL.QianZ. Z.LuS. S.FengF.HuC. Y.GongF. F.SunY. H. (2016). Prevalence of Internet addiction and its association with social support and other related factors among adolescents in China. Journal of Adolescence, 52, 103–111. https://doi.org/10.1016/j.adolescence.2016.07.012
72.
YatesT. M.GregorM. A.HavilandM. G. (2012). Child maltreatment, alexithymia, and problematic internet use in young adulthood. Cyberpsychology, Behavior, and Social Networking, 15(4), 219–225. https://doi.org/10.1089/cyber.2011.0427
ZarubinV. C.DammeK. S. F.VargasT.OsborneK. J.NortonE. S.Briggs-GowanM.MittalV. A. (2023). Neurodevelopmental vulnerability to psychosis: Developmentally-based methods enable detection of early life inhibitory control deficits that predict psychotic-like experiences at the transition to adolescence. Psychological Medicine, 53(16), 11–10. https://doi.org/10.1017/S003329172300171X
75.
ZhangF.ChengW.XiaoZ. P.LiuW. J. (2015). Study on reliability and validity of Chinese version of Ottawa self-injury inventory. Journal of Shanghai Jiaotong University (Medical Science), 35(3), 460–464. https://doi.org/10.3969/j.issn.1674-8115.2015.03.031
76.
ZhaoX.ZhangY.LiL.ZhouY. (2005). Evaluation on reliability and validity of Chinese version of childhood trauma questionnaire. Chinese Journal of Clinical Rehabilitation, 9(16), 209–211. https://doi.org/10.3321/j.issn:1673-8225.2005.16.037
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
