Journal of affective disorders · 2026
Association between post-traumatic stress disorder and non-suicidal self-injury in adolescents: Exploring the role of internet addiction and sleep disturbances.
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Chen Jiajia, Li Heting, Zhang Zigang, Mei Shiwei, Zhang Siteng, Yin Jia, Jiang Lihua, Zhao Li
Аннотация
BACKGROUND: The COVID-19 pandemic has substantially altered adolescents' learning and social environments, potentially increasing their vulnerability to post-traumatic stress disorder (PTSD) and non-suicidal self-injury (NSSI). Although PTSD is a recognized risk factor for NSSI, limited evidence exists regarding their association and underlying mechanisms during the pandemic's prolonged phase. This study examined the relationship between PTSD and NSSI and suggested exploratory evidence of potential pathways involving internet addiction and sleep disturbances.
METHODS: In June 2022, stratified cluster sampling was employed to recruit 5896 students in grades 5 to 9 from six schools in Chengdu, China. Participants completed the Children's Revised Impact of Event Scale (CRIES), Internet Addiction Test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Deliberate Self-Harm Inventory (DSHI). Spearman's correlation and exploratory analyses of potential indirect pathways (PROCESS 4.1, Model 6) were conducted.
RESULTS: 25.10% of adolescents reported NSSI. Internet addiction and sleep disturbances each independently associated with the relationship between PTSD and NSSI. Moreover, exploratory analyses suggested evidence of a potential sequential pathway.
LIMITATIONS: The use of self-report measures may introduce reporting bias. Due to the cross-sectional design and recall period inconsistencies, these findings should be interpreted as exploratory associations only; causal inferences and temporal ordering cannot be made.
CONCLUSION: As potentially modifiable factors, internet addiction and sleep disturbances may be relevant to prevention and intervention efforts for NSSI among adolescents with PTSD, though causal inferences cannot be drawn.
METHODS: In June 2022, stratified cluster sampling was employed to recruit 5896 students in grades 5 to 9 from six schools in Chengdu, China. Participants completed the Children's Revised Impact of Event Scale (CRIES), Internet Addiction Test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Deliberate Self-Harm Inventory (DSHI). Spearman's correlation and exploratory analyses of potential indirect pathways (PROCESS 4.1, Model 6) were conducted.
RESULTS: 25.10% of adolescents reported NSSI. Internet addiction and sleep disturbances each independently associated with the relationship between PTSD and NSSI. Moreover, exploratory analyses suggested evidence of a potential sequential pathway.
LIMITATIONS: The use of self-report measures may introduce reporting bias. Due to the cross-sectional design and recall period inconsistencies, these findings should be interpreted as exploratory associations only; causal inferences and temporal ordering cannot be made.
CONCLUSION: As potentially modifiable factors, internet addiction and sleep disturbances may be relevant to prevention and intervention efforts for NSSI among adolescents with PTSD, though causal inferences cannot be drawn.