Factors associated with emotional regulation self-efficacy in adolescents hospitalized for intentional drug and chemical overdose: a cross-sectional study.

Background: Intentional drug and chemical overdose (IDCO) represents a frequent, high-risk form of self-harm among adolescents, often involving accessible substances and carrying significant medical and psychological sequelae. Regulatory emotional self-efficacy (RESE), a core indicator of an individual's capacity for emotional management, is posited to critically influence both the motivation for and the clinical trajectory following IDCO. However, research specifically examining RESE within this distinct, high-acuity IDCO population remains scarce, limiting the development of targeted psychosocial interventions. Objective: This study aimed to explore the correlations between RESE and depressive symptoms, social support, family functioning, and clinical indicators, and to identify factors associated with RESE. As a secondary exploratory aim, we examined factors associated with clinical severity. Methods: A total of 145 adolescents aged 10-13 years hospitalized for Intentional drug and chemical overdose between July 2023 and June 2025 were enrolled. Participants were stratified by sex into female (n=99) and male (n=46) groups, and by drug category into psychotropic, neurological/antiepileptic, antibiotic/cold remedy, pesticide/household chemical, and other groups. All participants completed the Regulatory Emotional Self-Efficacy Scale, Depressive Symptom Scale, Social Support Scale, and Family Functioning Scale. Results: Regulatory emotional self-efficacy scores were significantly lower in females than in males (t=3.637, P = 0.001). Significant differences in self-efficacy scores were observed across drug categories (F = 3.456, P = 0.009), with the pesticide/household chemical group scoring the lowest. Regulatory emotional self-efficacy was negatively correlated with depressive symptoms (r=-0.47, P<0.001), positively correlated with social support (r=0.50, P<0.001). Multiple linear regression identified depressive symptoms (t=-3.372, P = 0.001), social support (t=3.876, P<0.001), and family functioning (t=-3.423, P = 0.001) as factors independently associated with regulatory emotional self-efficacy. In secondary exploratory analyzes, clinical severity was positively associated with depressive symptoms (OR = 1.578, 95% CI: 1.234-2.019, P<0.001), and pesticide/household chemical exposure was associated with higher odds of moderate-to-severe clinical presentation (OR = 3.434, 95% CI: 1.401-8.417, P = 0.007). Conclusion: RESE shows significant independent associations with depressive symptoms, social support, and family functioning in adolescents hospitalized for Intentional drug and chemical overdose. These cross-sectional findings identify potential targets for future prospective intervention research but do not directly support claims of improved management efficacy.