ArticleFrontiers in psychiatry2026
From anxiety and depression to non-suicidal self-injury in youths: the mediating effect of neuroticism and the moderating effect of thyroid hormones.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Non-suicidal self-injury (NSSI) is a common but maladaptive behavior among adolescents. Previous studies demonstrated a significant association of anxiety and depression with NSSI. However, the psychological and neuroendocrine mechanisms through which negative emotions influence NSSI remain unclear. The present study aimed to investigate whether the personality trait of neuroticism mediates the relationship between negative emotions and NSSI, and whether thyroid hormones moderate this pathway. Methods: A total of 104 Han Chinese adolescents and young adults (aged 12-22 years) who exhibited NSSI behaviors were recruited. The participants completed questionnaires to assess NSSI severity (Questionnaire for Middle School Students' Behavior, QMSSB), depressive symptoms (Hamilton Depression Rating Scale, HAMD), anxiety symptoms (Hamilton Anxiety Rating Scale, HAMA) and personality traits (Eysenck Personality Questionnaire, EPQ). Venous blood was collected for thyroid function tests (TT3, TT4, FT3, FT4 and TSH). Mediation and moderation analyses were conducted using the PROCESS plug-in for SPSS software. Results: Neuroticism mediated the relationship between emotional symptoms and NSSI. For HAMA in particular, neuroticism fully mediated the association with NSSI (effect = 0.0798, 95% bootstrap confidence interval [0.0387, 0.1367]). TT3 (b = 0.3112, Conclusions: Neuroticism mediates the mood-NSSI link. TT3 and FT3 positively moderate the depression-NSSI link, while TSH negatively moderates it. This negative moderating effect of TSH remains significant only in the high-neuroticism subgroup after FDR correction. These findings integrate psychological and neuroendocrine mechanisms for the identification and intervention of NSSI risk in youths.
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