The Relationship between Ambivalence over Emotional Expression and Nonsuicidal Self-Injury Among Chinese Adolescents: A Longitudinal Moderated Mediation Model

Abstract

Background

Nonsuicidal self-injury (NSSI) has become a significant mental health concern for adolescents. Previous empirical studies have shown that ambivalence over emotional expression is positively associated with negative emotions and behaviors. However, little is known about the relationship between ambivalence over emotional expression and NSSI among adolescents. Therefore, this study used a longitudinal design to examine the relationship between ambivalence over emotional expression and NSSI among Chinese adolescents, and also to explore the mediating and moderating mechanisms underlying this relationship.

Method

A total of 1,672 students (45.8% males; Mage = 16.12 years, SD = 1.56) in a middle school in Guangzhou were tracked. The investigation was conducted twice, with an interval of 6 months.

Results

Ambivalence over emotional expression was positively correlated with NSSI. After controlling for gender and baseline NSSI, anxiety symptoms fully mediated the association between ambivalence over emotional expression and NSSI. In addition, the relationship between ambivalence over emotional expression and NSSI was moderated by NSSI refusal self-efficacy.

Conclusions

These findings imply that to decrease ambivalence over emotional expression, to reduce anxiety symptoms, and to promote NSSI refusal self-efficacy may be useful for interventions and preventions of NSSI.

HIGHLIGHTS

• Tested the relationship between ambivalence over emotional expression and NSSI in adolescents.

• Examined a moderated-mediation model over six months.

• Found the mediated effect of anxiety symptoms and moderated effect of NSSI refusal self-efficacy in the relationship between ambivalence over emotional expression and NSSI.

Keywords:

• Adolescents
• ambivalence over emotional expression
• anxiety symptoms
• nonsuicidal self-injury
• NSSI refusal self-efficacy

AUTHOR CONTRIBUTIONS

Xinglin Zhou conceived of the study, conducted the statistical analysis and drafted the manuscript; Jiaqi Guo participated in the design of the study and helped revise the manuscript; Huijiao Wu, Danrui Chen participated in data collection and managed the literature searches; Chuhan Wang managed the literature searches and checked the manuscript; Jianing You participated in the design of the study and helped revise the manuscript. All authors contributed to and have approved the final manuscript.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [Grant No. 31771228], the National Social Science Foundation of China [Grant No. 19ZDA360], and the Special Funds for the Cultivation of Guangdong College Students’ Scientific and Technological Innovation (“Climbing Program” Special Funds) [Grant No. pdjh2021b0145]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This study was also supported by Research Center for Crisis Intervention and Psychological Service of Guangdong Province, South China Normal University and the base of psychological services and counseling for “Happiness” in Guangzhou.

Notes on contributors

Xinglin Zhou

Xinglin Zhou, Master, Jiaqi Guo, Dr., Huijiao Wu, Master, Danrui Chen, Master, Chuhan Wang, Master, and Jianing You, Prof., South China Normal University, Center for Studies of Psychological Application & School of Psychology, Guangzhou, China.

Jiaqi Guo

Xinglin Zhou, Master, Jiaqi Guo, Dr., Huijiao Wu, Master, Danrui Chen, Master, Chuhan Wang, Master, and Jianing You, Prof., South China Normal University, Center for Studies of Psychological Application & School of Psychology, Guangzhou, China.

Huijiao Wu

Xinglin Zhou, Master, Jiaqi Guo, Dr., Huijiao Wu, Master, Danrui Chen, Master, Chuhan Wang, Master, and Jianing You, Prof., South China Normal University, Center for Studies of Psychological Application & School of Psychology, Guangzhou, China.

Danrui Chen

Xinglin Zhou, Master, Jiaqi Guo, Dr., Huijiao Wu, Master, Danrui Chen, Master, Chuhan Wang, Master, and Jianing You, Prof., South China Normal University, Center for Studies of Psychological Application & School of Psychology, Guangzhou, China.

Chuhan Wang

Xinglin Zhou, Master, Jiaqi Guo, Dr., Huijiao Wu, Master, Danrui Chen, Master, Chuhan Wang, Master, and Jianing You, Prof., South China Normal University, Center for Studies of Psychological Application & School of Psychology, Guangzhou, China.

Jianing You

Xinglin Zhou, Master, Jiaqi Guo, Dr., Huijiao Wu, Master, Danrui Chen, Master, Chuhan Wang, Master, and Jianing You, Prof., South China Normal University, Center for Studies of Psychological Application & School of Psychology, Guangzhou, China.