AUTHOR=Li Xia , Liu Jiahe , Hu Yanling , Huang Xi , Li Yingxin , Li Yuan , Shi Zeyao , Yang Ru , Peng Hanmei , Ma Sisi , Wan Xingli , Peng Wei 

TITLE=The association of family functioning and suicide in children and adolescents: positive behavior recognition and non-suicidal self-injury as sequential mediators

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1505960

DOI=10.3389/fpubh.2025.1505960

ISSN=2296-2565

ABSTRACT=BackgroundSuicide is a major behavioral issue among children and adolescents, and family functioning potentially influencing its occurrence. Furthermore, positive behavior recognition, as a key component of positive youth development, may act as a mediating factor in the relationship between family functioning and suicide. Non-suicidal self-injury (NSSI) often co-occurs with suicide and may also mediate the impact of family functioning on suicide. Therefore, the aim of this study is to examine the role of family functioning in child and adolescent suicide, with positive behavior recognition and NSSI serving as sequential mediating factors.MethodsThe participants in this study were recruited from the Chengdu Positive Child Development (CPCD) cohort study. The analysis was based on the second round of cross-sectional data from the CPCD cohort. They were required to complete questionnaires that included measures of family functioning, suicide, positive behavior recognition, and NSSI. SPSS 26.0 and Mplus 8.3 were used for descriptive statistical analysis, correlation analysis and mediation effect analysis.ResultsA total of 8,124 participants completed the questionnaires, with an average age of 11.00 ± 2.18 years. The sample comprised 4,195 male and 3,929 female participants. The findings indicate that 17.93% of children and adolescents reported suicide thoughts, 10.06% had formulated suicide plans, and 8.64% had attempted suicide. Poor family functioning shows a significant positive correlation with suicide (r = 0.322, p < 0.01). The multiple mediation effect of positive behavior recognition and NSSI in the association between family functioning and suicide was statistically significant (β = 0.034, 95% CI = 0.027, 0.042).ConclusionThis study found that poor family functioning is a risk factor for suicide in children and adolescents, with positive behavior recognition and non-suicidal self-injury acting as sequential mediating factors.