Childhood maltreatment and non-suicidal self-injury: the mediating role of mentalization and depression.

Background: Childhood maltreatment (CM) is recognized as one of the primary factors increasing the risk of non-suicidal self-injury (NSSI).Objectives: This study aims to further understand the impact of different types of CM on the mechanisms underlying NSSI risk by examining the potential mediating roles of mentalization and depression.Method: A self-report survey was conducted with 1645 Chinese youths (933 males, 712 females; mean age = 18.25, SD = 0.64) to evaluate their experiences of CM, depression, mentalization, and NSSI frequency over the past year. Structural equation modelling was utilized to examine the direct and indirect pathways linking CM to NSSI risk via mentalization and depression.Results: The study found that emotional abuse, physical abuse, mentalization, and depression had significant direct effects on NSSI risk. Moreover, mentalization and depression mediated the relationship between emotional abuse and NSSI risk, while emotional neglect and physical neglect indirectly influenced NSSI risk only through depression. Physical abuse had a significant direct effect on NSSI risk, whereas sexual abuse did not show any direct or indirect effects.Conclusions: The findings suggest that childhood emotional abuse has a markedly different impact compared to other forms of CM. Interventions focused on improving mentalization may be particularly effective in addressing the effects of emotional abuse, mitigating depression, and reducing the risk of NSSI.