Direct and Indirect Links Between Peer Relationships, Father Involvement and Self-Harm Among Rural Chinese...

Objectives: Epidemiological surveys in rural China have reported comparatively high adolescent self-harm rates. Evidence on how peer relationships and father involvement jointly relate to this risk and on whether depression or anxiety helps to explain those links is more limited. This study investigated peer relationships and father involvement as two potential protective correlates of self-harm and assessed whether associations with self-harm were linked via depression and anxiety in a cross-sectional model. Methods: This study analysed publicly available data from the China Rural Children Mental Health Database. Data were collected in 16 rural primary schools across seven provinces. A sample of 588 adolescents aged 12-16 years with complete key variables was included. Structural equation modelling examined indirect associations between peer relationships, father involvement and self-harm through depression and anxiety. Results: Depression was positively and significantly associated with self-harm (β = 0.37, p < 0.001), while anxiety demonstrated only a marginally significant association with self-harm (β = 0.12, p = 0.06). Both peer relationships and father involvement were significantly associated with lower depression levels. The total associations for peer relationships (-0.23) exceeded those for father involvement (-0.16). The indirect associations of both variables with self-harm were linked primarily via depression. Conclusions: In this cross-sectional model, depression was the main pathway linking peer relationships and father involvement with self-harm, and the association for peer relationships was stronger than that for father involvement. Our results can guide assessment, prevention and intervention among adolescents in rural Chinese schools, including peer support and screening for depressive symptoms.