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ORIGINAL RESEARCH article
Front. Psychol.
Sec. Psychopathology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1546751
This article is part of the Research Topic Bridging the Gap: Physical Manifestations and Mental Health in Adolescents View all 4 articles
The mediating role of cognitive flexibility in the relationship between social support and Non-Suicidal Self-Injury among adolescents: a multicenter crosssectional study
Provisionally accepted- 1 Wenzhou Seventh People’s Hospital, Wenzhou, China
- 2 Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- 3 First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- 4 Third People's Hospital of Huzhou, Huzhou, China
Background: Non-suicidal self-injury (NSSI) is a prevalent and concerning behavior among adolescents worldwide, particularly in China. This study aimed to investigate the relationships between social support, cognitive flexibility, and NSSI, and to examine the potential mediating role of cognitive flexibility in the association between social support and NSSI among adolescents.A multicenter cross-sectional study was conducted with 2,109 adolescents (aged 12-18 years, mean age 15.00 ± 1.65 years, 52.3% female) recruited from 14 psychiatric hospitals/outpatient clinics. Participants completed self-report measures of social support and NSSI, along with a cognitive flexibility assessment using the Wisconsin Card Sorting Test. Structural equation modeling was employed to test the hypothesized mediation model.Social support was negatively associated with NSSI frequency (β = -0.11, p < 0.001) and positively related to cognitive flexibility (β = 0.09, p < 0.001). The mediation effect of cognitive flexibility was statistically significant (β = -0.01, 95% CI [-0.01, -0.01]), accounting for 8.33% of the total effect of social support on NSSI. Multi-group analysis revealed that the association between social support and cognitive flexibility was stronger in females (β = 0.11, p < 0.001) compared to males (β = 0.02, p > 0.05).This multicenter study provides evidence for the protective roles of social support and cognitive flexibility against NSSI in adolescents. The findings suggest that cognitive flexibility partially mediates the relationship between social support and NSSI, with notable gender differences. These results highlight the importance of enhancing both social support and cognitive flexibility in interventions aimed at reducing NSSI among adolescents.
Keywords: adolescents, cognitive flexibility, neuropsychological, Non-suicidal self-injury, social support
Received: 17 Dec 2024; Accepted: 26 Feb 2025.
Copyright: © 2025 Wang, Li, Ye, HONG and Bin. 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:
Wu Bin, Third People's Hospital of Huzhou, Huzhou, 313000, China
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