Exploring the Relationship Between Adverse Childhood Experiences and Non-suicidal Self-injury in Young Adults: The Role of Mental Health and Social Support

Non-suicidal self-injury (NSSI), as a common health hazard, has been recognized globally as a public health and clinical problem affecting the physical and mental health of adolescents and young adults. In this study, we aimed to explore (1) the moderating role of social support in adverse childhood experiences (ACEs) leading to the risk of NSSI; (2) mental health is a mediator of this relationship. The longitudinal study was conducted from May to June 2022, using a multistage cluster sampling method to acquire college students from freshmen to seniors in 4 years. A baseline follow-up was conducted 6 months later to exclude unqualified participants, and 1772 participants were eventually included. We measured social support, mental health, and NSSI using an electronic questionnaire. Moderation analysis was employed by PROCESS method to explore the relationship between above variables. The mean age was 20.53 +/- 1.65 years old in baseline. Multivariable linear regression suggests that the high-level ACEs (beta = 0.037, 95% CI 0.021-0.061) were associated with higher NSSI. There is also the interaction between ACEs, social support, and mental health. In the complex relationship between ACEs and NSSI, social support played a moderator role, and mental health played a mediator role, respectively. ACEs can lead to the occurrence of NSSI, and comprehensive and effective attention to social support and psychological problems and their roles in ACEs are crucial for the prevention of NSSI. This study not only supplements the results of previous studies but also provides a complex mechanism at the sociological level for the prevention and control of NSSI.