Childhood Trauma, Psychological Distress, and Non-Suicidal Self-Injury among Secondary school students

Corresponding author: Liang Xue Mei, 406062507@qq.com

DOI: 10.12201/bmr.202602.00088

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  Abstract: Objective To explore the association between childhood trauma, psychological distress (including emotional symptoms and sleep disturbances), and non-suicidal self-injury (NSSI) behaviors in secondary school students, and to investigate the mediating role of psychological distress in the relationship between childhood trauma and NSSI. Methods From October 2024 to March 2025, 16,310 students from five secondary schools in Luzhou City were recruited via convenience sampling for an online survey. Participants completed the Childhood Trauma Questionnaire (CTQ), Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire (PHQ-9), Insomnia Severity Index (ISI), and the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire. Statistical analyses were conducted using SPSS 22.0 and R software, and the mediating effect of psychological distress was tested using the bootstrap method. Results The prevalence of NSSI among participants was 20.40%, with occasional and repetitive NSSI accounting for 16.68% and 3.72%, respectively. Childhood trauma, psychological distress, and NSSI were significantly positively correlated. Mediation analysis indicated that psychological distress partially mediated the relationship between childhood trauma and NSSI, accounting for 17.10% of the total effect. Conclusions Childhood trauma is associated with NSSI in secondary school students both directly and indirectly through psychological distress. Since psychological distress partially mediates the relationship between childhood trauma and NSSI, early identification and intervention targeting emotional and sleep disturbances are crucial for the prevention and management of NSSI.

  Key words: Secondary school students; ?Childhood trauma; Non-suicidal self - injury; Psychological distress; Emotional symptoms; Sleep disturbances

  Submit time: 23 February 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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