The Relationship Between Nonsuicidal Self-Injury and Depression Symptoms in Chinese Adolescents: A Cross-Lagged Panel Network Analysis.

Introduction: Nonsuicidal self-injury (NSSI) and depression often co-occur among adolescents and lead to severe mental health problems. However, it is not clear how NSSI and depression causally relate to each other at a symptom level, with respect to gender differences. Therefore, this study aimed to explore the co-occurring patterns of NSSI and depression symptoms and examined gender differences.

Methods: The present study conducted cross-sectional and cross-lagged network analyses between NSSI and depression symptoms among adolescent girls and boys. A total of 1122 Chinese students (50.4% girls; mean age = 13.51 years, SD = 1.10) completed a survey at two waves.

Results: The results revealed that (1) the depression symptoms "sad" and "depressed" were the highest and most stable Expected Influence centrality nodes. The depression symptom "scared" acted as a bridging node across genders, both in cross-sectional and cross-lagged panel networks. (2) For girls, depression symptoms at W1 predicted NSSI at W2. The depression symptoms "tired" and "lack of hope" at W1 were the strongest predictors of NSSI symptoms at W2. (3) For boys, NSSI and depression symptoms displayed a bidirectional relationship through the "scared" and "lonely".

Discussion: These findings provide valuable insights into the distinct gendered temporal relationships between NSSI and depression at the symptom level and underscore the practical value of targeted, gender-informed treatment and screening for adolescents.