College of Education, Hunan Agricultural University, Changsha, China.
Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.
Front Public Health. 2024 May 15;12:1406283. doi: 10.3389/fpubh.2024.1406283. eCollection 2024.
Non-suicidal self-injury is a widespread mental health concern among adolescents. This study aimed to examine the relationship between self-esteem, depression, and self-injury among adolescents using a longitudinal research design.
The Self-Esteem Scale (SES), Child Depression Inventory (CDI), and Adolescent Self-Injury Scale (ASIS) were used to follow up 1,265 junior middle school students on three occasions with six-month intervals.
At all three time points, there were significant gender differences in self-esteem, depression, and self-injury. Self-esteem was negatively correlated with depression and self-injury at all three time points, while depression and self-injury were significantly positively correlated. Cross-lagged analysis revealed that self-esteem at Time 1 (T1) did not significantly predict self-injury at Time 2 (T2), but self-esteem (T2) significantly predicted self-injury at Time 3 (T3; = -0.079, < 0.05). Similarly, self-injury (T1) significantly predicted self-esteem (T2; = -0.140, < 0.001), and self-injury (T2) significantly predicted self-esteem (T3; = -0.071, < 0.01). Horizontal and longitudinal mediating analysis showed that depression served as a complete mediator in both the pathway from self-esteem to self-injury and from self-injury to self-esteem. Cross-lagged analysis showed that self-esteem (T1) significantly predicts depression (T2; = -0.070, < 0.05), which in turn predict self-injury (T3; = 0.126, < 0.001). Similarly, self-injury (T1) predicted depression (T2; = 0.055, < 0.05), which further predicted self-esteem (T3; = -0.218, < 0.001).
The self-esteem, depression, and self-injury of adolescents are closely related; self-esteem and self-injury predict each other; self-esteem indirectly affects self-injury through depression; and self-injury indirectly affects self-esteem through depression. Based on the relationship of bi-directional prediction of self-esteem and self-injury mediated by depression, this study proposes a theoretical model of depression-mediated self-esteem and self-injury cycle.
非自杀性自伤是青少年中广泛存在的心理健康问题。本研究旨在采用纵向研究设计，考察自尊、抑郁和自伤之间的关系。
使用自尊量表（SES）、儿童抑郁量表（CDI）和青少年自伤量表（ASIS）对 1265 名初中生进行了三次随访，间隔六个月。
在所有三个时间点，自尊、抑郁和自伤都存在显著的性别差异。自尊在所有三个时间点都与抑郁和自伤呈负相关，而抑郁和自伤则呈显著正相关。交叉滞后分析显示，T1 时的自尊对 T2 时的自伤没有显著预测作用，但 T2 时的自尊对 T3 时的自伤有显著预测作用（β=-0.079， <0.05）。同样，T1 时的自伤对 T2 时的自尊有显著预测作用（β=-0.140， <0.001），T2 时的自伤对 T3 时的自尊有显著预测作用（β=-0.071， <0.01）。水平和纵向中介分析表明，抑郁在自尊到自伤和自伤到自尊的两条路径中均为完全中介。交叉滞后分析显示，T1 时的自尊对 T2 时的抑郁有显著预测作用（β=-0.070， <0.05），而抑郁又对 T3 时的自伤有显著预测作用（β=0.126， <0.001）。同样，T1 时的自伤对 T2 时的抑郁有显著预测作用（β=0.055， <0.05），抑郁又对 T3 时的自尊有显著预测作用（β=-0.218， <0.001）。
青少年的自尊、抑郁和自伤密切相关；自尊和自伤相互预测；自尊通过抑郁间接影响自伤；自伤通过抑郁间接影响自尊。基于自尊和自伤通过抑郁的双向预测关系，本研究提出了抑郁介导的自尊和自伤循环的理论模型。
