Family Functioning and NSSI Urges among Chinese Adolescents: A Three-wave Chain Multiple Mediation Model.

Family functioning is used to evaluate the functioning of a family system, which exerts a huge influence on non-suicidal self-injury (NSSI). However, little is known about how family functioning relates to NSSI among adolescents, and existing research mainly depends on cross-sectional design, which cannot capture dynamic changes between variables. Additionally, NSSI urge has been established as a robust predictor of NSSI engagement and is clinically important. Guided by the integrated model of NSSI, the current study investigated two potential mediators (emotion regulation and self-esteem) of the relations between family functioning and NSSI urges to address these gaps. Participants were 1298 Chinese adolescents (50.5% male; Mage at Wave 2 = 15.08 years) from a three-wave longitudinal study with data spanning ten months. The results supported the chain multiple mediation model. Specifically, valid family functioning prevented NSSI urges through three indirect paths: (a) higher level of self-esteem; (b) more cognitive reappraisal to higher self-esteem; (c) less expressive suppression to higher self-esteem. The prediction of family functioning on cognitive reappraisal was weaker among girls, while the prediction of self-esteem on NSSI urges was stronger. These findings indicate that high family functioning is a powerful protective factor of NSSI urges, and NSSI interventions should aim to improve adolescents' family functioning, with attention to reinforcing emotion regulation and self-esteem, especially for girls.