Between solitude and self-harm: A mixed-methods study on loneliness, emotional regulation and the buffering role of...

This study aims to explore the self-harming behaviours and emotional regulation mechanisms among university students within the context of their experiences of loneliness. A mixed-methods design was employed. In the first phase, semi-structured interviews were conducted with 20 university students with a self-harm history or high loneliness levels to investigate their subjective loneliness experiences. In the second phase, an ecological momentary assessment approach was applied over seven consecutive days to collect quantitative data from 120 university students on loneliness, emotional regulation difficulties and self-harm urges, capturing their dynamic interrelations. Findings indicated that loneliness not only directly increased the tendency toward self-harm but also exerted an indirect effect through emotional regulation difficulties. Moreover, active social interactions were found to partially buffer this negative effect. The study deepens the understanding of psychological distress among university students by revealing the complex emotional processes underlying self-harm. The findings of this study can provide a theoretical basis for the screening and management of self-harm risk in university students' psychological outpatient clinics, thereby contributing to the optimisation of mental health service models for university students.