ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Adolescent and Young Adult Psychiatry
This article is part of the Research TopicAdolescent Emotional Disorders and Suicide Self-Harm Crisis InterventionView all 41 articles
The relationship between childhood trauma and non-suicidal self-injury in adolescents with depressive disorders: The mediating role of alexithymia and coping strategies
Provisionally accepted
- 1Guangdong Provincial People's Hospital, Guangzhou, China
- 2Guangdong Mental Health Center, Guangzhou, China
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Background: Non-suicidal self-injury (NSSI) is highly prevalent among adolescents with depressive disorders and is associated with adverse clinical outcomes. Childhood trauma is a well-established risk factor for NSSI, yet the psychological mechanisms underlying this association remain unclear. This study examined the mediating roles of alexithymia and coping strategies in the relationship between childhood trauma and NSSI among adolescents with depressive disorders. Methods: A total of 129 patients (aged 12-18 years, mean age = 14.74) with depressive disorders and non-suicidal self-injury (NSSI) were recruited from the inpatient and outpatient departments of the hospital. Diagnostic interviews were conducted to diagnose depressive disorders and NSSI by professional psychiatrists. Demographic characteristics of those depressed adolescents were collected using a self-administered questionnaire. The Childhood Trauma Questionnaire Short Form (CTQ-SF), the Adolescent Non-suicidal Self‐injury Assessment Questionnaire (ANSAQ), the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20-C) and the Simplified Coping Style Questionnaire (SCSQ) were used to obtain information about childhood trauma experience, NSSI, alexithymia and coping. Results: Emotional neglect and emotional abuse were the most prevalent trauma subtypes. Childhood trauma was positively correlated with NSSI (r = 0.599, p < 0.001), alexithymia (r = 0.525, p < 0.001), and negative coping (r = 0.338, p < 0.001), and negatively correlated with positive coping (r = –0.392, p < 0.001). Mediation analyses showed that alexithymia (β = 0.075, 17.08%) and negative coping (β = 0.032, 7.29%) partially mediated the relationship between childhood trauma and NSSI. Moreover, alexithymia and negative coping formed a significant chain mediation pathway (β = 0.028, 6.38%). Conclusions: Childhood trauma contributes to NSSI both directly and indirectly via alexithymia and maladaptive coping. Targeted interventions addressing emotional awareness and coping flexibility may help reduce the risk of self-injury among adolescents with depressive disorders and trauma histories.
Keywords: adolescents, alexithymia, childhood trauma, coping, Depression, Non-suicidal self-injury
Received: 12 Nov 2025; Accepted: 19 Jan 2026.
Copyright: © 2026 Liu, Zhou, Liu and Hou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cailan Hou
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