Exploring the mediating role of self-hate in the relationship between adverse childhood experiences and non-suicidal self-injury among adolescents

Background: Non-suicidal self-injury (NSSI) has become a serious global problem among adolescents. This study aimed to explore the relationships between adverse childhood experiences, self-hate, and non-suicidal self-injury in adolescents. Methods: A total of 7009 adolescents participated in a survey from August 1 to December 31, 2023. The survey comprised the revised Adverse Childhood Experience (ACE) Questionnaire, Self-Hate Scale, and Adolescent NonSuicidal Self-Injury Assessment Questionnaire. SPSS 22.0 was utilized for data entry and analysis. Spearman's correlation analysis was employed to examine the relationships between the variables. The bias-corrected nonparametric percentile bootstrap method was used to test the significance of the mediating effect. Results: Adverse childhood experiences, self-hate, and non-suicidal self-injury were positively correlated. Adverse childhood experiences directly affected self-injury without obvious tissue damage. Self-hate mediated the relationship between adverse childhood experiences and self-injury without obvious tissue damage. Adverse childhood experiences directly affected self-injury with obvious tissue damage. Self-hate mediated between adverse childhood experiences and self-injury with obvious tissue damage. Limitations: The data were cross-sectional, and the effects of adverse childhood experiences were not immediate. Further, because this was a subjective study, reporting bias was inevitable. Finally, future research should expand the discussion and improve the global relevance of the study. Conclusion: Self-hate mediates the relationship between adverse childhood experiences and NSSI in adolescents. This study explores the underlying mechanisms and influencing factors of NSSI in adolescents and provides important evidence-based support for the prevention and intervention of NSSI in adolescents with different characteristics to maintain adolescents' physical and mental health. Implications and contribution: Given the close relationships found between adverse childhood experiences, selfhate, and non-suicidal self-injury (NSSI) in adolescents, it is crucial to address adverse childhood experiences to prevent and treat NSSI. Providing necessary psychological support and interventions can help foster positive self-awareness, enhance self-esteem and self-efficacy, reduce self-disgust, and mitigate the negative effects of adverse childhood experiences.