This longitudinal study examined how shame and loneliness relate to nonsuicidal self-injury (NSSI) over 12 months in 664 Chinese adolescents (mean age 13.82 years), including whether loneliness mediates the shame-to-NSSI pathway, using latent growth modeling and cross-lagged panel models across three time points.
Both initial levels and rates of change in shame and loneliness were significantly linked to NSSI trajectories. Cross-lagged analyses showed shame and loneliness at each time point predicted subsequent NSSI. Loneliness mediated the shame→NSSI pathway: shame at T1 → loneliness at T2 → NSSI at T3.
Single-province Chinese sample (Anhui) limits generalizability. Study relies on self-report measures, which may underestimate NSSI in stigmatized cultural contexts. The 6-month intervals between assessments may miss shorter-term fluctuations in shame, loneliness, or NSSI.
Clinicians working with adolescents should screen for both shame and loneliness as upstream risk factors for NSSI — reducing loneliness may be a concrete intervention target to interrupt the shame-to-self-injury pathway. Interventions in East Asian contexts should specifically address culturally-shaped shame experiences.
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