Paternal emotional warmth buffers maternal rejection in adolescent NSSI: a network and Bayesian analysis

BACKGROUND: Non-suicidal self-injury (NSSI) is a worldwide adolescent mental health concern. OBJECTIVE: This study examined how parenting styles influence individuals with NSSI within the framework of interpersonal relationships and emotion regulation. PARTICIPANTS AND SETTING: From June 2023 to September 2024, a total of 5,675 Chinese participants aged between 15 and 20 years were evaluated on their parenting style, thoughts and behaviors regarding NSSI, along with other variables related to interpersonal relationships and emotion regulation. Within this sample, 425 participants reported engaging in Non-Suicidal Self-Injury (NSSI) (age 16.67 ± 1.07 years; male n = 173 [40.71%], female n = 252 [59.29%]), while 5,250 reported no NSSI behavior (age 16.92 ± 1.09 years; male n = 2,326 [44.30%], female n = 2,924 [55.70%]). METHODS: We constructed the emotion regulation-interpersonal relationships network and identified discrepant relationships related to NSSI through network comparison. Bridging analysis validated the mediating nodes, while Bayesian networks inferred potential causal relationships. Structural Equation Modeling was applied to quantify strengths between key nodes. RESULTS: Compared with healthy controls, the NSSI group exhibited significantly more negative parenting styles. In the general population, mother rejection and father emotional warmth (FEW) exhibited the highest centrality. FEW and depression (Patient Health Questionnaire-9 (PHQ-9)) emerged as bridging nodes connecting these relationships. Bayesian networks indicated that father rejection, mother emotional warmth, and PHQ-9 were identified as direct predictors of NSSI severity (path coefficients = 0.17, ˗0.19, and 0.27). Parents influenced various aspects of NSSI thoughts and behaviors. CONCLUSIONS: The prevention and intervention of adolescent NSSI depend on the establishment of positive coping mechanisms by the adolescents, combined with interpersonal warmth from peers and parents. Clinically, this finding underscores the significance of fathers enhancing their emotional expression skills for the prevention and treatment of adolescent NSSI. TRIAL REGISTRATION: The research and analysis plan of this project was preregistered on the Open Science Framework (https://osf.io/s9wdb).