Adolescent non-suicidal self-injury: The moderating influence of social support utilization on depression

Adolescence is a period marked by physiological and psychological imbalances, which pose an increased risk for adolescents with major depressive disorder (MDD) to commit non-suicidal self-injury (NSSI).

To investigate the moderating role of social support utilization in depression and NSSI among adolescents with MDD.

This cross-sectional study enrolled 314 adolescents with MDD (258 with NSSI, 56 without) from a Chinese tertiary psychiatric hospital (2021-2023). Participants completed validated scales, including the self-esteem scale, the Barratt impulsiveness scale, the self-rating depression scale, and the teenager social support rating scale. Logistic regression and hierarchical regression analyses were used to examine predictors of NSSI and the moderating effect of social support utilization.

Results showed that the NSSI group had higher depression levels, lower self-esteem, and greater impulsivity. While overall social support was higher in the NSSI group, social support utilization significantly moderated the depression-NSSI relationship. Specifically, higher utilization levels weakened the association between depression and NSSI (β = -0.001, P < 0.05).

These findings suggest that effective utilization of social support, rather than its mere presence, is crucial in reducing NSSI risk among depressed adolescents.