ArticleFrontiers in psychiatry2026
Childhood maltreatment and adolescent non-suicidal self-injury: cross-sectional conditional process and network analyses of depressive symptoms and physical activity.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Childhood maltreatment is associated with adolescent non-suicidal self-injury (NSSI), but the roles of depressive symptoms and physical activity remain unclear. We examined these relationships using variable-level and network approaches. Methods: This cross-sectional study included 2,354 adolescents recruited by convenience sampling from 30 secondary schools in six Chinese provinces. The 12-item behavior dimension of the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire was the primary outcome. Covariate-adjusted indirect-effect and conditional process analyses used HC3 standard errors and 5,000 bootstrap samples; an 18-node regularized partial-correlation network was also estimated. Results: Childhood maltreatment correlated positively with depressive symptoms (r = .365) and NSSI behavior (r = .366), while depressive symptoms correlated positively with NSSI behavior (r = .531; all p < .001). Physical activity was negatively associated with depressive symptoms and NSSI behavior. Depressive symptoms showed a significant cross-sectional indirect association between childhood maltreatment and NSSI behavior (effect = .084, 95% bootstrap CI [.072, .098]). The depressive symptoms × physical activity interaction was statistically significant but very small (B = -.015, 95% CI [-.021, -.010]; ΔR Conclusions: Depressive symptoms statistically accounted for part of the childhood maltreatment-NSSI association. Although physical activity significantly interacted with depressive symptoms, the interaction explained only 1.3% of additional variance and had limited practical significance. The weak physical activity connections in the network further suggested little unique symptom-level association after shared variance was controlled. Because the data were cross-sectional, temporal mediation and causal inferences cannot be established, and clinical benefit cannot be inferred.
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