Adverse childhood experiences and non-suicidal self-injury in adolescents: the roles of depressive symptoms and teacher care

BackgroundNon-suicidal self-injury (NSSI) has become an increasingly prominent mental health problem during adolescence and often co-occurs with depressive symptoms, anxiety, personality-related difficulties, and experiences of childhood trauma, forming a complex psychosocial risk structure. From a risk and protective factor perspective, the present study examined the associations among adverse childhood experiences (ACEs), depressive symptoms, perceived teacher care, and NSSI among Chinese adolescents.MethodsThe participants were 2,221 junior high school students from three schools in China. Data were collected using the Childhood Trauma Questionnaire, the Adolescent Non-Suicidal Self-Injury Questionnaire, a depression scale, and a teacher care scale.ResultsAdverse childhood experiences and depressive symptoms were significantly positively associated with NSSI, whereas perceived teacher care was significantly negatively associated with NSSI. Higher levels of ACE exposure and more severe depressive symptoms were associated with higher levels of NSSI, while higher levels of teacher care were associated with lower levels of NSSI. Moreover, among adolescents reporting higher levels of perceived teacher care, the positive associations between ACEs and NSSI and between depressive symptoms and NSSI were attenuated, suggesting that teacher care, as an external support resource in the school context, may play an important protective role.ConclusionsAdverse childhood experiences and depressive symptoms are important risk factors for adolescent NSSI, whereas teacher care plays a significant protective role in the school context. School-based prevention and intervention efforts should prioritize adolescents with high levels of ACE exposure and pronounced depressive symptoms, while strengthening teacher care to enhance protective resources. Future research should further explore how specific dimensions and timing of ACEs, trajectories of depressive symptoms, and multiple sources of social support jointly influence the development and maintenance of NSSI in adolescents.