Childhood maltreatment and non-suicidal self-injury in college students: chain mediation by alexithymia and depression along with a symptom-level network analysis

BackgroundChildhood maltreatment is a well-established risk factor for various mental health and behavioral problems, including non-suicidal self-injury (NSSI). Despite its prevalence, the associations between childhood maltreatment and NSSI, particularly as mediated by alexithymia and depression, remain not fully explored. This study primarily employs structural equation modeling (SEM) to test the hypothesized relationships between childhood maltreatment, alexithymia, depression, and NSSI, and additionally incorporates network analysis to examine the symptom-level connections among these constructs at the micro level, complementing the macro-level insights from SEM.MethodWe recruit a sample of 1,414 college students. Participants complete the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Toronto Alexithymia Scale (TAS-20), the Self-Rating Depression Scale (SDS), and the NSSI Behavior Assessment Questionnaire. We then employ SEM to test the hypothesized mediation model and use network analysis to visualize the interconnections among the specific dimensions of childhood maltreatment, alexithymia, depression, and NSSI.ResultsSEM results indicate that alexithymia and depression significantly mediate the relationship between childhood maltreatment and NSSI, forming a chain mediating effect. Network analysis identifies “Difficulty identifying feelings” (DIF) as the most central node in the network. Moreover, DIF, NSSI, and Affective Symptoms (AS) were identified as key bridge symptoms connecting the clusters within the network.ConclusionOur findings highlight the importance of focusing on the emotional processing deficit and emotional problems in the intervention and prevention of NSSI among college students.