Pan B, Guo MY, Gong Y, Lin Z, Zhang BR. Protective role of perceived social support against adolescent self-injury addiction: Serial mediation of negative emotion and impulsivity. World J Psychiatry 2026; 16(2): 113573 [DOI: 10.5498/wjp.v16.i2.113573]
Corresponding Author of This Article
Bing-Ren Zhang, PhD, Lecturer, School of Clinical Medicine, Hangzhou Normal University, No. 2318 Yuhangtang Road, Hangzhou 311121, Zhejiang Province, China. bingrenz@hznu.edu.cn
Research Domain of This Article
Psychiatry
Article-Type of This Article
Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 19, 2026 (publication date) through Feb 2, 2026
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Journal Information of This Article
Publication Name
World Journal of Psychiatry
ISSN
2220-3206
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Pan B, Guo MY, Gong Y, Lin Z, Zhang BR. Protective role of perceived social support against adolescent self-injury addiction: Serial mediation of negative emotion and impulsivity. World J Psychiatry 2026; 16(2): 113573 [DOI: 10.5498/wjp.v16.i2.113573]
Bing Pan, Zheng Lin, Department of Psychiatry, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Mei-Yi Guo, Bing-Ren Zhang, School of Clinical Medicine, Hangzhou Normal University, Hangzhou 311121, Zhejiang Province, China
Yun Gong, Department of Pediatrics, Hangzhou First People’s Hospital, Hangzhou 310009, Zhejiang Province, China
Co-corresponding authors: Bing-Ren Zhang and Zheng Lin.
Author contributions: Zhang BR and Lin Z contribute equally to this study as co-corresponding authors; Pan B contributed to the study design and collected the data, Guo MY contributed to the data analysis; Gong Y and Lin Z contributed to patient enrollment; Zhang BR conceived the study and led the data interpretation; Pan B and Zhang BR completed first draft of the paper; all authors revised it and approved the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of the Second Affiliated Hospital, Zhejiang University School of Medicine (No. 2024-0075) and was conducted in accordance with the Helsinki Declaration of Human Rights.
Informed consent statement: Written informed consents were obtained from all participants' legal guardians.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement:
The datasets used and/or analyzed during the current study are available from the corresponding or first author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bing-Ren Zhang, PhD, Lecturer, School of Clinical Medicine, Hangzhou Normal University, No. 2318 Yuhangtang Road, Hangzhou 311121, Zhejiang Province, China. bingrenz@hznu.edu.cn
Received: September 1, 2025 Revised: October 14, 2025 Accepted: November 24, 2025 Published online: February 19, 2026 Processing time: 151 Days and 15.9 Hours
Abstract
BACKGROUND
Repeated non-suicidal self-injury (NSSI) behaviors are frequently associated with negative emotions, impulsivity and addictive-like characteristics.
AIM
To explore the protective role of perceived social support against self-injury addiction among adolescents engaging in NSSI.
METHODS
This cross-sectional study enrolled 102 Chinese adolescents with NSSI from outpatient clinics at a local hospital between January 2024 and April 2024, and their perceived social support, depression and anxiety emotions, impulsivity, and self-injury addiction were assessed using the Multidimensional Scale of Perceived Social Support (MSPSS), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Barratt Impulsiveness Scale (BIS-11), and addiction subscale of the Revised Chinese Version of Ottawa Self-injury Inventory (ROSI-addiction).
RESULTS
Among adolescents with NSSI, ROSI-addiction scores were negatively correlated with MSPSS factors and positively correlated with SAS scores, SDS scores, and all BIS-11 factors except Cognitive instability. Meanwhile, MSPSS factors were negatively correlated with SAS and SDS scores; SAS and SDS scores exhibited positively correlations with the BIS-11 dimensions of Attention, Perseverance, Self-control and Cognitive complexity. Moreover, perceived social support demonstrated both direct and indirect negative relations with self-injury addiction, mediated by anxiety, depression and impulsivity.
CONCLUSION
Negative emotions and impulsivity mediated the inverse correlation between perceived social support and self-injury addiction in adolescents with NSSI. Enhancing available social support, and regulating anxiety, depression and impulsivity may be fundamental for intervention of in NSSI.
Core Tip: This study reveals a novel psychological mechanism: Perceived social support protects adolescents with non-suicidal self-injury from self-injury addiction by sequentially alleviating negative emotions (anxiety/depression) and impulsivity. These findings highlight the critical role of social support as a protective factor and propose that interventions targeting emotional regulation and impulse control may effectively break the cycle of self-injury addiction. This serial mediation model offers a theoretical basis for developing multi-level clinical strategies for adolescents with non-suicidal self-injury.
