ArticleBMC psychiatry2026
Alexithymia and non-suicidal self-ınjury in adolescents: the roles of emotion dysregulation, impulsivity, and self-esteem.
Article in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- A study on the explicit self-injurious behaviors of adolescent patients with depression, their implicit self-injurious attitudes, and their relationship with self-esteem levels.Frontiers in public health · 2026Article
- The interactive turn in generative AI for self-harm.Frontiers in psychiatry · 2026Article
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Authors and funding
6 authors.
Funding
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Abstract
backgroundNon-suicidal self-injury (NSSI) is highly prevalent among adolescents and is associated with significant psychosocial impairment. Although alexithymia has been linked to NSSI in previous studies, the psychological mechanisms that may explain this association remain unclear. The present study aimed to concurrently examine emotion regulation difficulties, impulsivity, and self-esteem as mediators of the association between alexithymia and NSSI in a clinical adolescent sample.
methodsThe study sample consisted of 437 adolescent outpatients (79.4% girls; Mage = 15.4 years), including 147 who reported NSSI in the past year and 290 who did not. Alexithymia, emotion regulation difficulties, impulsivity and self-esteem were measured. Gender-stratified structural equation modeling (SEM) was conducted to examine whether emotion regulation difficulties, impulsivity, and self-esteem mediated the association between alexithymia and NSSI, with indirect effects evaluated using bootstrapping.
resultsThe NSSI group exhibited higher levels of alexithymia, emotion regulation difficulties, impulsivity and lower self-esteem than non-NSSI peers. Alexithymia was associated with all three mediators in both genders. Mediation analyses revealed significant indirect effects for emotion regulation difficulties, impulsivity, and self-esteem in the alexithymia-NSSI association among girls. Among boys, none of the specific indirect effects reached statistical significance; however, the total indirect effect was significant.
conclusionsThese findings highlight emotion dysregulation, impulsivity, and self-esteem as clinically relevant processes associated with alexithymia and NSSI in a clinical adolescent sample, particularly among girls. Addressing these processes in clinical assessment and intervention may contribute to more targeted approaches for reducing NSSI in adolescents. Longitudinal studies, particularly including larger male samples, are needed to clarify the directionality of these associations and to further examine gender-specific patterns. CLINICAL TRIAL NUMBER: Not applicable.
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