Adolescent non-suicidal self-injury: Network analysis of identified core intervention targets and differences across...

Non-suicidal self-injury (NSSI) is increasingly prevalent among adolescents, with an earlier age of onset. However, existing research has yet to fully elucidate the interactive mechanisms among multidimensional factors. This study aims to identify core intervention targets and examine differences in network structures across educational stages.

Self-reported questionnaire data were collected from 7048 adolescents aged 11-19 years. The survey examined environmental (e.g., adverse childhood experiences, bullying), family (e.g., ineffective parenting), and individual (e.g., depression, impulsivity, psychological resilience) factors, as well as NSSI behaviors and functions. Network analysis was applied to identify connectivity patterns and central nodes across subgroups.

The NSSI group (n = 2992) demonstrated a more densely connected network with 47 edges, whereas the non-NSSI group (n = 4056) had 42 edges, indicating a more fragmented structure. Psychological resilience and impulsivity were identified as central nodes in both groups. Junior high and senior high school students exhibited similar network structures, while the network of secondary vocational school students was the least connected, with impulsivity as the core node. The network structures of the three NSSI functions were similar, with the self-negative reinforcement function showing higher connectivity than the strategic social and emotional expression functions.

Self-reported data may be affected by recall bias and stigma. Network analysis identifies associations but does not infer causality.

Psychological resilience and impulsivity are key intervention targets for adolescent NSSI. Special attention should be given to impulse control and bullying prevention among secondary vocational school students.