Rumination, loneliness, and non-suicidal self-injury among adolescents with major depressive disorder: The moderating role of resilience

Adolescents often experience negative emotions, such as depression and anxiety, due to rapid biological, cognitive, and social changes during this developmental stage. In recent years, the non-suicidal self-injury (NSSI) among adolescents with Major Depressive Disorder (MDD) has garnered increasing attention, with rumination identified as a significant risk factor for its occurrence. This study established a moderated mediation model to examine the impact of rumination on NSSI among adolescents with MDD and its underlying mechanisms. The final research sample consisted of 1,601 adolescents with MDD (18.2% males, mean age = 14.85 years, SD = 1.65) from 14 psychiatric/general hospitals across nine provinces in China. Participants completed self-report questionnaires assessing NSSI, rumination, loneliness, and resilience. Results indicated that rumination contribute to NSSI via loneliness during adolescence, whereas resilience may buffer the adverse effects of rumination on NSSI, implying the potential effectiveness of reducing loneliness and promoting resilience in the intervention and prevention of NSSI. These findings further illuminate the mechanisms underlying the development of NSSI, aiding in its prediction and prevention among adolescents, thereby assisting them in better coping with emotional and behavioral developmental challenges during adolescence.