Chu Chengjing, Zhou Yanhua, Lin Zhixiong, Wang Zihan, Zhang Jie, Lu Yibin
Department of Psychology, School of Humanities and Management, Guangdong Medical University, Dongguan, China.
Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
Front Psychiatry. 2025 Aug 29;16:1590441. doi: 10.3389/fpsyt.2025.1590441. eCollection 2025.
Nonsuicidal self-injurious behavior (NSSI) is highly prevalent in adolescents and strongly associated with early trauma. Emerging theories have indicated that the occurrence of NSSI results from the interaction of individual biological vulnerability and environmental risk; however, the underlying mechanisms are not yet clear. This study sought to investigate the psychological and pathophysiological mechanisms underlying the development of self-injury behavior through environmental, psychological, and physiological factors. We hypothesized that mentalization mediates the relationship between childhood trauma and NSSI, and further explored whether oxytocin (OT) has the potential to serve as an informative biomarker of social functioning for people with NSSI.
This study investigated NSSI, childhood trauma, and mentalizing in 1313 junior high school students to develop and test a mediated model of mentalizing in which childhood trauma affects NSSI. Subsequently, the relationship between peripheral salivary OT levels and NSSI in a cohort of 109 individuals with suicidal self-injurious behavior and 113 healthy controls.
The NSSI detection rate was 28.2% in this study. Females had a greater frequency of NSSI, hypomentalization and lower hypermentalization.The structural equation modeling (SEM) results revealed that the indirect effect of childhood trauma on NSSI through hypomentalization was 0.091 (95% CI [0.066, 0.120], P< 0.001). The indirect effect of childhood trauma on NSSI through hypermentalization was 0.037 (95% CI [0.025, 0.049], P < 0.001). OT levels were not significantly correlated with hypermentalization, hypomentalization, or childhood trauma ( > 0.05).
The present study revealed that mentalizing partially mediated the associations between childhood trauma and NSSI, suggesting that the mentalizing trauma model is equally applicable to the community NSSI population. This is the first study to explore the relationship between peripheral OT levels and NSSI behavior, with results suggesting that baseline salivary OT concentrations are not reliable biomarkers for NSSI in community samples.
非自杀性自伤行为（NSSI）在青少年中极为普遍，且与早期创伤密切相关。新出现的理论表明，NSSI的发生是个体生物易感性与环境风险相互作用的结果；然而，其潜在机制尚不清楚。本研究旨在通过环境、心理和生理因素来探究自伤行为发展背后的心理和病理生理机制。我们假设心理化调节童年创伤与NSSI之间的关系，并进一步探讨催产素（OT）是否有可能作为NSSI患者社会功能的一种信息性生物标志物。
本研究对1313名初中生的NSSI、童年创伤和心理化进行调查，以建立和检验一个心理化的中介模型，其中童年创伤影响NSSI。随后，在109名有自杀性自伤行为的个体和113名健康对照组成的队列中，研究外周唾液OT水平与NSSI之间的关系。
本研究中NSSI检出率为28.2%。女性NSSI、心理化不足及过度心理化的频率更高。结构方程模型（SEM）结果显示，童年创伤通过心理化不足对NSSI的间接效应为0.091（95%CI[0.066，0.120]，P<0.001）。童年创伤通过过度心理化对NSSI的间接效应为0.037（95%CI[0.025，0.049]，P<0.001）。OT水平与过度心理化、心理化不足或童年创伤均无显著相关性（P>0.05）。
本研究表明，心理化部分介导了童年创伤与NSSI之间的关联，这表明心理化创伤模型同样适用于社区NSSI人群。这是第一项探讨外周OT水平与NSSI行为之间关系
