Network Analysis of Childhood Maltreatment, Anxiety, and Addictive Non-Suicidal Self-injury in Adolescents

Non-suicidal self-injury (NSSI) in adolescents is becoming a widespread health issue. Recent studies have suggested that repetitive NSSI is crucial in NSSI adolescents and can be conceptualized as an “addictive behavior.” The aim of this cross-sectional study was to explore the network relationships among child maltreatment, anxiety, and addictive NSSI in adolescents. In total, 542 adolescents (14.07 ± 2.15 years old, 18.6% males) with NSSI behavior completed the related questionnaires. Two types of psychometric approaches were used to analyze the data. First, the network analysis showed that emotional abuse (Expected Influence: 1.20) had the most central role among the networks, and the edges of emotional abuse–anxiety (weight: 0.25), emotional abuse-addictive NSSI (weight: 0.20), and anxiety–addictive NSSI (weight: 0.19) showed stronger positive associations of trans-symptom edges. Second, the network comparison test was used to examine the network differences between the male and female groups; however, no network differences were found. Overall, among all types of childhood maltreatment, our results suggest that emotional abuse should be more emphasized to prevent long-term mental adverse outcomes and addictive NSSI, and that anxiety may also mediate emotional abuse and addictive NSSI in NSSI adolescents.