{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:30:10Z","timestamp":1792791010691,"version":"4.5.0"},"reference-count":86,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"the National Clinical Key Specialty Project Foundation"},{"name":"Anhui Medical University Clinical Science Foundation","id":[{"id":"https:\/\/ror.org\/03xb04968","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Research Fund of Anhui Institute of translational medicine","award":["2022zhyx-B01"],"award-info":[{"award-number":["2022zhyx-B01"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-08423-2","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T23:01:45Z","timestamp":1751410905000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Alexithymia and self-injury functions as mediators between childhood maltreatment and nonsuicidal self-injury in adolescents with major depressive disorder"],"prefix":"10.1038","volume":"15","author":[{"given":"Yudong","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guodong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Geng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangfen","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangwang","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanzhong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"8423_CR1","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1002\/wps.20050","volume":"12","author":"DA Regier","year":"2013","unstructured":"Regier, D. A., Kuhl, E. A. & Kupfer, D. J. The DSM-5: classification and criteria changes. World Psychiatry. 12, 92\u201398 (2013).","journal-title":"World Psychiatry"},{"key":"8423_CR2","first-page":"100794","volume":"37","author":"D Qu","year":"2023","unstructured":"Qu, D. et al. Non-suicidal self-injury in Chinese population: A scoping review of prevalence, method, risk factors and preventive interventions. Lancet Reg. Health: Western Pac. 37, 100794 (2023).","journal-title":"Lancet Reg. Health: Western Pac."},{"key":"8423_CR3","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.jad.2023.09.036","volume":"343","author":"H Deng","year":"2023","unstructured":"Deng, H. et al. The pooled prevalence and influential factors of non-suicidal self-injury in non-clinical samples during the COVID-19 outbreak: A meta-analysis. J. Affect. Disord. 343, 109\u2013118 (2023).","journal-title":"J. Affect. Disord"},{"key":"8423_CR4","doi-asserted-by":"publisher","first-page":"6011","DOI":"10.1017\/S0033291722003178","volume":"53","author":"G Kiekens","year":"2023","unstructured":"Kiekens, G. et al. A longitudinal investigation of non-suicidal self-injury persistence patterns, risk factors, and clinical outcomes during the college period. Psychol. Med. 53, 6011\u20136026 (2023).","journal-title":"Psychol. Med."},{"key":"8423_CR5","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.jad.2023.10.110","volume":"345","author":"Y Zhong","year":"2024","unstructured":"Zhong, Y. et al. A machine learning algorithm-based model for predicting the risk of non-suicidal self-injury among adolescents in Western china: A multicentre cross-sectional study. J. Affect. Disord. 345, 369\u2013377 (2024).","journal-title":"J. Affect. Disord"},{"key":"8423_CR6","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1186\/s12889-024-18483-0","volume":"24","author":"S O\u2019Donnell","year":"2024","unstructured":"O\u2019Donnell, S., Egan, T., Clarke, N. & Richardson, N. Prevalence and associated risk factors for suicidal ideation, non-suicidal self-injury and suicide attempt among male construction workers in Ireland. BMC Public. Health. 24, 1263 (2024).","journal-title":"BMC Public. Health"},{"key":"8423_CR7","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.jad.2023.11.080","volume":"347","author":"XC Chen","year":"2024","unstructured":"Chen, X. C. et al. Mediating role of anxiety and impulsivity in the association between child maltreatment and lifetime non-suicidal self-injury with and without suicidal self-injury. J. Affect. Disord. 347, 57\u201365 (2024).","journal-title":"J. Affect. Disord"},{"key":"8423_CR8","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1186\/s12888-023-04938-y","volume":"23","author":"B Zhang","year":"2023","unstructured":"Zhang, B. et al. Relationship between alexithymia, loneliness, resilience and non-suicidal self-injury in adolescents with depression: A multi-center study. BMC Psychiatry. 23, 445 (2023).","journal-title":"BMC Psychiatry"},{"key":"8423_CR9","doi-asserted-by":"publisher","first-page":"1434958","DOI":"10.3389\/fpubh.2024.1434958","volume":"12","author":"Y Wu","year":"2024","unstructured":"Wu, Y., Zhang, Y., Wang, C. & Huang, B. A meta-analysis on the lifetime and period prevalence of self-injury among adolescents with depression. Front. Public. Health. 12, 1434958 (2024).","journal-title":"Front. Public. Health"},{"key":"8423_CR10","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1186\/s12888-024-06041-2","volume":"24","author":"Y Li","year":"2024","unstructured":"Li, Y. et al. The association between child maltreatment, cognitive reappraisal, negative coping styles, and non-suicidal self-injury in adolescents with major depressive disorder. BMC Psychiatry. 24, 592 (2024).","journal-title":"BMC Psychiatry"},{"key":"8423_CR11","first-page":"1201","volume":"54","author":"L Wei","year":"2023","unstructured":"Wei, L. et al. Association between medication compliance and various risky behaviors in patients with schizophrenia. Sichuan Da Xue Xue Bao Yi Xue Ban. 54, 1201\u20131207 (2023).","journal-title":"Sichuan Da Xue Xue Bao Yi Xue Ban"},{"key":"8423_CR12","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1017\/S0033291721002245","volume":"53","author":"G Kiekens","year":"2023","unstructured":"Kiekens, G. et al. Non-suicidal self-injury among first-year college students and its association with mental disorders: results from the world mental health international college student (WMH-ICS) initiative. Psychol. Med. 53, 875\u2013886 (2023).","journal-title":"Psychol. Med."},{"key":"8423_CR13","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1586\/14737175.2013.811976","volume":"13","author":"M Pompili","year":"2013","unstructured":"Pompili, M. et al. Mood disorders medications: predictors of nonadherence - review of the current literature. Expert Rev. Neurother. 13, 809\u2013825 (2013).","journal-title":"Expert Rev. Neurother."},{"key":"8423_CR14","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1007\/s10964-024-01970-3","volume":"53","author":"C Schmidt","year":"2024","unstructured":"Schmidt, C. et al. Identifying high-risk subgroups of college students with non-suicidal self-injury: A latent profile analysis and two-years follow-up study. J. Youth Adolesc. 53, 1370\u20131382 (2024).","journal-title":"J. Youth Adolesc."},{"key":"8423_CR15","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1007\/s10802-019-00531-8","volume":"47","author":"T Buelens","year":"2019","unstructured":"Buelens, T., Luyckx, K., Gandhi, A., Kiekens, G. & Claes, L. Non-suicidal self-injury in adolescence: longitudinal associations with psychological distress and rumination. J. Abnorm. Child. Psychol. 47, 1569\u20131581 (2019).","journal-title":"J. Abnorm. Child. Psychol."},{"key":"8423_CR16","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.jad.2024.07.105","volume":"363","author":"BJ Turner","year":"2024","unstructured":"Turner, B. J., Porter, A. C. & Robillard, C. L. Average ages of onset and time to transition between self-injurious thoughts and behaviors: retrospective evidence from two developmentally distinct samples. J. Affect. Disord. 363, 465\u2013473 (2024).","journal-title":"J. Affect. Disord"},{"key":"8423_CR17","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1177\/08862605231197747","volume":"39","author":"X Gong","year":"2024","unstructured":"Gong, X. & Zhang, L. Childhood maltreatment and non-suicidal self-injury in adolescents: testing a moderated mediating model. J. Interpers. Violence. 39, 925\u2013948 (2024).","journal-title":"J. Interpers. Violence"},{"key":"8423_CR18","doi-asserted-by":"publisher","first-page":"e0308038","DOI":"10.1371\/journal.pone.0308038","volume":"19","author":"J Hamilton","year":"2024","unstructured":"Hamilton, J., Welham, A., Morgan, G. & Jones, C. Exploring the prevalence of childhood adversity among university students in the united kingdom: A systematic review and meta-analysis. PloS One. 19, e0308038 (2024).","journal-title":"PloS One"},{"key":"8423_CR19","doi-asserted-by":"publisher","first-page":"e152","DOI":"10.1017\/S2045796020000682","volume":"29","author":"L Lu","year":"2020","unstructured":"Lu, L. et al. Childhood trauma and suicidal ideation among Chinese university students: the mediating effect of internet addiction and school bullying victimisation. Epidemiol. Psychiatric Sci. 29, e152 (2020).","journal-title":"Epidemiol. Psychiatric Sci."},{"key":"8423_CR20","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1111\/head.13773","volume":"60","author":"F Mansuri","year":"2020","unstructured":"Mansuri, F., Nash, M. C., Bakour, C. & Kip, K. Adverse childhood experiences (ACEs) and headaches among children: A cross-sectional analysis. Headache 60, 735\u2013744 (2020).","journal-title":"Headache"},{"key":"8423_CR21","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/j.jad.2018.12.096","volume":"246","author":"CM van der Feltz-Cornelis","year":"2019","unstructured":"van der Feltz-Cornelis, C. M. et al. Adverse childhood experiences (ACE) in outpatients with anxiety and depressive disorders and their association with psychiatric and somatic comorbidity and revictimization. Cross-sectional observational study. J. Affect. Disord. 246, 458\u2013464 (2019).","journal-title":"J. Affect. Disord"},{"key":"8423_CR22","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1007\/s10578-023-01508-x","volume":"55","author":"L Wang","year":"2024","unstructured":"Wang, L., Zou, H. O., Liu, J. & Hong, J. F. Prevalence of adverse childhood experiences and their associations with non-suicidal self-injury among Chinese adolescents with depression. Child. Psychiatry Hum. Dev. 55, 1441\u20131451 (2024).","journal-title":"Child. Psychiatry Hum. Dev."},{"key":"8423_CR23","doi-asserted-by":"publisher","first-page":"e47","DOI":"10.1192\/j.eurpsy.2024.1760","volume":"67","author":"YY Huang","year":"2024","unstructured":"Huang, Y. Y. et al. Childhood socio-economic disadvantages versus adverse care experiences: mediation and moderation impacts on late-life depressive symptoms. Eur. Psychiatry: J. Association Eur. Psychiatrists. 67, e47 (2024).","journal-title":"Eur. Psychiatry: J. Association Eur. Psychiatrists"},{"key":"8423_CR24","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1016\/j.jad.2024.08.155","volume":"365","author":"Y Du","year":"2024","unstructured":"Du, Y. et al. The mediating role of family functioning between childhood trauma and depression severity in major depressive disorder and bipolar disorder. J. Affect. Disord. 365, 443\u2013450 (2024).","journal-title":"J. Affect. Disord"},{"key":"8423_CR25","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1016\/j.jad.2024.06.037","volume":"361","author":"M Peng","year":"2024","unstructured":"Peng, M. et al. The effects of childhood trauma on nonsuicidal self-injury and depressive severity among adolescents with major depressive disorder: the different mediating roles of positive and negative coping styles. J. Affect. Disord. 361, 508\u2013514 (2024).","journal-title":"J. Affect. Disord"},{"key":"8423_CR26","doi-asserted-by":"publisher","first-page":"1336631","DOI":"10.3389\/fpsyg.2024.1336631","volume":"15","author":"P Cao","year":"2024","unstructured":"Cao, P. et al. Predictors of non-suicidal self-injury in adolescents with depressive disorder: the role of alexithymia, childhood trauma, and body investment. Front. Psychol. 15, 1336631 (2024).","journal-title":"Front. Psychol."},{"key":"8423_CR27","first-page":"520","volume":"53","author":"Y Zhong","year":"2020","unstructured":"Zhong, Y., Yang, Y., Zhang, Y. & Liu, H. Childhood trauma experiences and their impact on non-suicidal self-injury in adolescents with first episode depressive disorder. Chin. J. Psychiatry. 53, 520\u2013525 (2020).","journal-title":"Chin. J. Psychiatry"},{"key":"8423_CR28","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1080\/13811118.2023.2237083","volume":"28","author":"Y Erol","year":"2024","unstructured":"Erol, Y. & Inozu, M. An investigation of the mediating roles of emotion regulation difficulties, distress tolerance, self-compassion, and self-disgust in the association between childhood trauma and nonsuicidal self-injury. Archives Suicide Research: Official J. Int. Acad. Suicide Res. 28, 815\u2013829 (2024).","journal-title":"Archives Suicide Research: Official J. Int. Acad. Suicide Res."},{"key":"8423_CR29","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1080\/00332747.2021.1989854","volume":"85","author":"Y Ta\u015f Torun","year":"2022","unstructured":"Ta\u015f Torun, Y., Gul, H., Yaylali, F. H. & Gul, A. Intra\/interpersonal functions of non-suicidal self-injury in adolescents with major depressive disorder: the role of emotion regulation, alexithymia, and childhood traumas. Psychiatry 85, 86\u201399 (2022).","journal-title":"Psychiatry"},{"key":"8423_CR30","doi-asserted-by":"publisher","first-page":"113126","DOI":"10.1016\/j.psychres.2020.113126","volume":"290","author":"CSM Ng","year":"2020","unstructured":"Ng, C. S. M. & Chan, V. C. W. Prevalence and associated factors of alexithymia among Chinese adolescents in Hong Kong. Psychiatry Res. 290, 113126 (2020).","journal-title":"Psychiatry Res."},{"key":"8423_CR31","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1002\/jclp.22314","volume":"73","author":"L McGillivray","year":"2017","unstructured":"McGillivray, L., Becerra, R. & Harms, C. Prevalence and demographic correlates of alexithymia: A comparison between Australian psychiatric and community samples. J. Clin. Psychol. 73, 76\u201387 (2017).","journal-title":"J. Clin. Psychol."},{"key":"8423_CR32","first-page":"156","volume":"11","author":"L Sirri","year":"2023","unstructured":"Sirri, L. Prevalence and correlates of alexithymia in the general population. Mediterranean J. Clin. Psychol. 11, 156\u2013156 (2023).","journal-title":"Mediterranean J. Clin. Psychol."},{"key":"8423_CR33","doi-asserted-by":"crossref","unstructured":"Point, C. et al. Impact of alexithymia on the lipid profile in major depressed individuals. J Lipids 5450814 (2022). (2022).","DOI":"10.1155\/2022\/5450814"},{"key":"8423_CR34","doi-asserted-by":"publisher","first-page":"774952","DOI":"10.3389\/fpsyt.2021.774952","volume":"12","author":"X Wang","year":"2021","unstructured":"Wang, X. et al. Prevalence and correlates of alexithymia and its relationship with life events in Chinese adolescents with depression during the COVID-19 pandemic. Front. Psychiatry. 12, 774952 (2021).","journal-title":"Front. Psychiatry"},{"key":"8423_CR35","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1016\/j.jad.2022.12.065","volume":"324","author":"DA Preece","year":"2023","unstructured":"Preece, D. A. et al. Alexithymia and emotion regulation. J. Affect. Disord. 324, 232\u2013238 (2023).","journal-title":"J. Affect. Disord"},{"key":"8423_CR36","doi-asserted-by":"publisher","first-page":"116099","DOI":"10.1016\/j.psychres.2024.116099","volume":"340","author":"M Kierait\u00e9","year":"2024","unstructured":"Kierait\u00e9, M. et al. Our similarities are different the relationship between alexithymia and depression. Psychiatry Res. 340, 116099 (2024).","journal-title":"Psychiatry Res."},{"key":"8423_CR37","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s13034-022-00477-8","volume":"16","author":"WC Tang","year":"2022","unstructured":"Tang, W. C., Lin, M. P., Wu, J. Y. W., Lee, Y. T. & You, J. Mediating role of depression in the association between alexithymia and nonsuicidal self-injury in a representative sample of adolescents in Taiwan. Child Adolesc. Psychiatry Mental Health. 16, 43 (2022).","journal-title":"Child Adolesc. Psychiatry Mental Health"},{"key":"8423_CR38","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1037\/0022-006X.72.5.885","volume":"72","author":"MK Nock","year":"2004","unstructured":"Nock, M. K. & Prinstein, M. J. A functional approach to the assessment of self-mutilative behavior. J. Consult Clin. Psychol. 72, 885\u2013890 (2004).","journal-title":"J. Consult Clin. Psychol."},{"key":"8423_CR39","doi-asserted-by":"publisher","first-page":"755857","DOI":"10.3389\/fpsyt.2021.755857","volume":"12","author":"D Qu","year":"2022","unstructured":"Qu, D. et al. Psychometric properties of the Chinese version of the functional assessment of self-mutilation (FASM) in Chinese clinical adolescents. Front. Psychiatry. 12, 755857 (2022).","journal-title":"Front. Psychiatry"},{"key":"8423_CR40","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1016\/j.jad.2017.11.073","volume":"227","author":"PJ Taylor","year":"2018","unstructured":"Taylor, P. J. et al. A meta-analysis of the prevalence of different functions of non-suicidal self-injury. J. Affect. Disord. 227, 759\u2013769 (2018).","journal-title":"J. Affect. Disord"},{"key":"8423_CR41","doi-asserted-by":"publisher","first-page":"1378492","DOI":"10.3389\/fpsyt.2024.1378492","volume":"15","author":"Y Zhao","year":"2024","unstructured":"Zhao, Y., Zhao, X., Zhou, Y. & Liu, L. Self-injury functions mediate the association between anxiety and self-injury frequency among depressed Chinese adolescents: sex differences. Front. Psychiatry. 15, 1378492 (2024).","journal-title":"Front. Psychiatry"},{"key":"8423_CR42","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1080\/10538712.2022.2047855","volume":"31","author":"ZM El Nagar","year":"2022","unstructured":"El Nagar, Z. M., Barakat, D. H., Rabie, M. A. E. M., Thabeet, D. M. & Mohamed, M. Y. Relation of non-suicidal self-harm to emotion regulation and alexithymia in sexually abused children and adolescents. J. Child. Sex. Abuse. 31, 431\u2013446 (2022).","journal-title":"J. Child. Sex. Abuse"},{"key":"8423_CR43","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1192\/bjp.2019.243","volume":"217","author":"J Nyberg","year":"2020","unstructured":"Nyberg, J., Gustavsson, S., \u00c5berg, M. A. I., Kuhn, H. G. & Waern, M. Late-adolescent risk factors for suicide and self-harm in middle-aged men: explorative prospective population-based study. Br. J. Psychiatry. 217, 370\u2013376 (2020).","journal-title":"Br. J. Psychiatry"},{"key":"8423_CR44","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/S0145-2134(02)00541-0","volume":"27","author":"DP Bernstein","year":"2003","unstructured":"Bernstein, D. P. et al. Development and validation of a brief screening version of the childhood trauma questionnaire. Child. Abuse Negl. 27, 169\u2013190 (2003).","journal-title":"Child. Abuse Negl."},{"key":"8423_CR45","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.chiabu.2019.03.009","volume":"91","author":"J He","year":"2019","unstructured":"He, J., Zhong, X., Gao, Y., Xiong, G. & Yao, S. Psychometric properties of the Chinese version of the childhood trauma questionnaire-short form (CTQ-SF) among undergraduates and depressive patients. Child. Abuse Negl. 91, 102\u2013108 (2019).","journal-title":"Child. Abuse Negl."},{"key":"8423_CR46","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/0022-3999(94)90005-1","volume":"38","author":"RM Bagby","year":"1994","unstructured":"Bagby, R. M., Parker, J. D. A. & Taylor, G. J. The twenty-item Toronto alexithymia scale\u2014I. Item selection and cross-validation of the factor structure. J. Psychosom. Res. 38, 23\u201332 (1994).","journal-title":"J. Psychosom. Res."},{"key":"8423_CR47","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1016\/j.comppsych.2007.04.007","volume":"48","author":"X Zhu","year":"2007","unstructured":"Zhu, X. et al. Cross-cultural validation of a Chinese translation of the 20-item Toronto alexithymia scale. Compr. Psychiatry. 48, 489\u2013496 (2007).","journal-title":"Compr. Psychiatry"},{"key":"8423_CR48","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1023\/A:1012779403943","volume":"23","author":"KL Gratz","year":"2001","unstructured":"Gratz, K. L. Measurement of deliberate self-harm: preliminary data on the deliberate self-harm inventory. J. Psychopathol. Behav. Assess. 23, 253\u2013263 (2001).","journal-title":"J. Psychopathol. Behav. Assess."},{"key":"8423_CR49","doi-asserted-by":"publisher","first-page":"3361","DOI":"10.3390\/ijerph16183361","volume":"16","author":"WL Chen","year":"2019","unstructured":"Chen, W. L. & Chun, C. C. Association between emotion dysregulation and distinct groups of non-suicidal self-injury in Taiwanese female adolescents. Int. J. Environ. Res. Public. Health. 16, 3361 (2019).","journal-title":"Int. J. Environ. Res. Public. Health"},{"key":"8423_CR50","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1177\/014662167700100306","volume":"1","author":"LS Radloff","year":"1977","unstructured":"Radloff, L. S. The CES-D scale: A self-report depression scale for research in the general population. Appl. Psych Meas. 1, 385\u2013401 (1977).","journal-title":"Appl. Psych Meas."},{"key":"8423_CR51","doi-asserted-by":"crossref","unstructured":"Gao, D., Li, R. & Yang, Y. The impact of social activities on mental health among older adults in China. Front Public. Health 12,1422246 (2024).","DOI":"10.3389\/fpubh.2024.1422246"},{"key":"8423_CR52","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.jad.2024.03.108","volume":"355","author":"J Cheng","year":"2024","unstructured":"Cheng, J. et al. Self-injury and suicidal ideation among Chinese adolescents involved in different subtypes of aggression: the role of gender. J. Affect. Disord. 355, 371\u2013377 (2024).","journal-title":"J. Affect. Disord"},{"key":"8423_CR53","doi-asserted-by":"crossref","unstructured":"Cipriano, A., Cella, S. & Cotrufo, P. Nonsuicidal self-injury: A systematic review. Front Psychol 8, 1946 (2017).","DOI":"10.3389\/fpsyg.2017.01946"},{"key":"8423_CR54","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1037\/1082-989X.4.1.84","volume":"4","author":"RC MacCallum","year":"1999","unstructured":"MacCallum, R. C., Widaman, K. F., Zhang, S. & Hong, S. Sample size in factor analysis. Psychol. Methods. 4, 84 (1999).","journal-title":"Psychol. Methods"},{"key":"8423_CR55","unstructured":"Moshagen, M., Bader, M. & semPower Power analyses for SEM. (2024). https:\/\/cran.r-project.org\/web\/packages\/semPower\/index.html"},{"key":"8423_CR56","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v048.i02","volume":"48","author":"Y Rosseel","year":"2012","unstructured":"Rosseel, Y. & lavaan An R package for structural equation modeling. J. Stat. Softw. 48, 1\u201336 (2012).","journal-title":"J. Stat. Softw."},{"key":"8423_CR57","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.3758\/s13428-020-01500-6","volume":"53","author":"AP Christensen","year":"2021","unstructured":"Christensen, A. P. & Golino, H. On the equivalency of factor and network loadings. Behav. Res. Methods. 53, 1563\u20131580 (2021).","journal-title":"Behav. Res. Methods"},{"key":"8423_CR58","doi-asserted-by":"publisher","first-page":"1696","DOI":"10.1111\/eip.13115","volume":"15","author":"J Lee","year":"2021","unstructured":"Lee, J. et al. Non-suicidal self\u2010injury is associated with psychotic like experiences, depression, and bullying in Korean adolescents. Early Interv Psychia. 15, 1696\u20131704 (2021).","journal-title":"Early Interv Psychia"},{"key":"8423_CR59","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1080\/13811118.2013.824828","volume":"18","author":"CH Leong","year":"2014","unstructured":"Leong, C. H., Wu, A. M. S. & Poon, M. M. Measurement of perceived functions of Non-Suicidal Self-Injury for Chinese adolescents. Arch. Suicide Res. 18, 193\u2013212 (2014).","journal-title":"Arch. Suicide Res."},{"key":"8423_CR60","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1186\/s12888-021-03469-8","volume":"21","author":"J Ambrosetti","year":"2021","unstructured":"Ambrosetti, J. et al. Psychiatric emergency admissions during and after COVID-19 lockdown: Short-term impact and long-term implications on mental health. BMC Psychiatry. 21, 465 (2021).","journal-title":"BMC Psychiatry"},{"key":"8423_CR61","doi-asserted-by":"publisher","first-page":"nsae053","DOI":"10.1093\/scan\/nsae053","volume":"19","author":"Y Zou","year":"2024","unstructured":"Zou, Y. et al. Altered dynamic functional connectivity of nucleus accumbens subregions in major depressive disorder: the interactive effect of childhood trauma and diagnosis. Soc. Cogn. Affect. Neur. 19, nsae053 (2024).","journal-title":"Soc. Cogn. Affect. Neur"},{"key":"8423_CR62","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1038\/s41380-022-01907-x","volume":"28","author":"S Ochi","year":"2023","unstructured":"Ochi, S. & Dwivedi, Y. Dissecting early life stress-induced adolescent depression through epigenomic approach. Mol. Psychiatry. 28, 141\u2013153 (2023).","journal-title":"Mol. Psychiatry"},{"key":"8423_CR63","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.jad.2024.08.028","volume":"365","author":"AC Del Giacco","year":"2024","unstructured":"Del Giacco, A. C., Morales, A. M., Jones, S. A., Barnes, S. J. & Nagel, B. J. Ventral striatal-cingulate resting-state functional connectivity in healthy adolescents relates to later depression symptoms in adulthood. J. Affect. Disord. 365, 205\u2013212 (2024).","journal-title":"J. Affect. Disord"},{"key":"8423_CR64","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jad.2024.02.071","volume":"357","author":"DA Preece","year":"2024","unstructured":"Preece, D. A. et al. Alexithymia profiles and depression, anxiety, and stress. J. Affect. Disord. 357, 116\u2013125 (2024).","journal-title":"J. Affect. Disord"},{"key":"8423_CR65","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/j.jad.2021.08.126","volume":"295","author":"AT Peters","year":"2021","unstructured":"Peters, A. T. et al. Inflammation, depressive symptoms, and emotion perception in adolescence. J. Affect. Disord. 295, 717\u2013723 (2021).","journal-title":"J. Affect. Disord"},{"key":"8423_CR66","doi-asserted-by":"publisher","DOI":"10.1007\/s10578-024-01737-8","author":"J Yang","year":"2024","unstructured":"Yang, J., Wang, L., Jin, C., Wu, Y. W. & Zhao, K. The Bridge between childhood trauma and alexithymia among adolescents with depressive and bipolar disorders: A network Bridge analysis. Child. Psychiatry Hum. Dev. https:\/\/doi.org\/10.1007\/s10578-024-01737-8 (2024).","journal-title":"Child. Psychiatry Hum. Dev."},{"key":"8423_CR67","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.jad.2012.06.033","volume":"146","author":"MY G\u00fcle\u00e7","year":"2013","unstructured":"G\u00fcle\u00e7, M. Y. et al. Effects of childhood trauma on somatization in major depressive disorder: the role of alexithymia. J. Affect. Disord. 146, 137\u2013141 (2013).","journal-title":"J. Affect. Disord"},{"key":"8423_CR68","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1186\/s12888-024-05902-0","volume":"24","author":"Y Xie","year":"2024","unstructured":"Xie, Y., Ma, D., Duan, Y., Cao, J. & Wei, J. The association among negative life events, alexithymia, and depressive symptoms in a psychosomatic outpatient sample. BMC Psychiatry. 24, 451 (2024).","journal-title":"BMC Psychiatry"},{"key":"8423_CR69","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/j.jad.2019.11.144","volume":"263","author":"G Serafini","year":"2020","unstructured":"Serafini, G. et al. Hopelessness and its correlates with clinical outcomes in an outpatient setting. J. Affect. Disord. 263, 472\u2013479 (2020).","journal-title":"J. Affect. Disord"},{"key":"8423_CR70","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/1047840X.2014.940781","volume":"26","author":"JJ Gross","year":"2015","unstructured":"Gross, J. J. Emotion regulation: current status and future prospects. Psychol. Inq. 26, 1\u201326 (2015).","journal-title":"Psychol. Inq."},{"key":"8423_CR71","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1146\/annurev-clinpsy-032814-112739","volume":"11","author":"G Sheppes","year":"2015","unstructured":"Sheppes, G., Suri, G. & Gross, J. J. Emotion regulation and psychopathology. Annu. Rev. Clin. Psycho. 11, 379\u2013405 (2015).","journal-title":"Annu. Rev. Clin. Psycho"},{"key":"8423_CR72","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1111\/bjdp.12445","volume":"41","author":"KMY Chan","year":"2023","unstructured":"Chan, K. M. Y., Hong, R. Y., Ong, X. L. & Cheung, H. S. Emotion dysregulation and symptoms of anxiety and depression in early adolescence: bidirectional longitudinal associations and the antecedent role of parent-child attachment. Brit J. Dev. Psychol. 41, 291\u2013305 (2023).","journal-title":"Brit J. Dev. Psychol."},{"key":"8423_CR73","doi-asserted-by":"publisher","first-page":"2193524","DOI":"10.1080\/20008066.2023.2193524","volume":"14","author":"S Timmer-Murillo","year":"2023","unstructured":"Timmer-Murillo, S. et al. Facets of emotion dysregulation differentially predict depression and PTSD symptom severity following traumatic injury. Eur. J. Psychotraumatology. 14, 2193524 (2023).","journal-title":"Eur. J. Psychotraumatology"},{"key":"8423_CR74","doi-asserted-by":"publisher","first-page":"15326","DOI":"10.1038\/s41598-021-94799-w","volume":"11","author":"M Morr","year":"2021","unstructured":"Morr, M. et al. Insula reactivity mediates subjective isolation stress in alexithymia. Sci. Rep. 11, 15326 (2021).","journal-title":"Sci. Rep."},{"key":"8423_CR75","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1037\/emo0001002","volume":"21","author":"M Franz","year":"2021","unstructured":"Franz, M. et al. It is in your face-alexithymia impairs facial mimicry. Emot. (Washington D C). 21, 1537\u20131549 (2021).","journal-title":"Emot. (Washington D C)"},{"key":"8423_CR76","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1080\/02699931.2020.1747991","volume":"35","author":"N Ridout","year":"2021","unstructured":"Ridout, N., Smith, J. & Hawkins, H. The influence of alexithymia on memory for emotional faces and realistic social interactions. Cognition Emot. 35, 540\u2013558 (2021).","journal-title":"Cognition Emot."},{"key":"8423_CR77","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1186\/s12888-023-04808-7","volume":"23","author":"H He","year":"2023","unstructured":"He, H. et al. Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis. BMC Psychiatry. 23, 301 (2023).","journal-title":"BMC Psychiatry"},{"key":"8423_CR78","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.jad.2024.05.077","volume":"359","author":"X Li","year":"2024","unstructured":"Li, X. et al. The associations of social health, self-injurious thoughts and behaviors with or without childhood trauma: A UK biobank study. J. Affect. Disord. 359, 145\u2013157 (2024).","journal-title":"J. Affect. Disord"},{"key":"8423_CR79","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1159\/000085148","volume":"74","author":"C Spitzer","year":"2005","unstructured":"Spitzer, C., Siebel-Jurges, U., Barnow, S., Grabe, H. J. & Freyberger, H. J. Alexithymia and interpersonal problems. Psychother. Psychosom. 74, 240\u2013246 (2005).","journal-title":"Psychother. Psychosom."},{"key":"8423_CR80","doi-asserted-by":"publisher","first-page":"103477","DOI":"10.1016\/j.brat.2019.103477","volume":"123","author":"AH Gerber","year":"2019","unstructured":"Gerber, A. H., Girard, J. M., Scott, S. B. & Lerner, M. D. Alexithymia - not autism - is associated with frequency of social interactions in adults. Behav. Res. Ther. 123, 103477 (2019).","journal-title":"Behav. Res. Ther."},{"key":"8423_CR81","doi-asserted-by":"publisher","first-page":"2794","DOI":"10.1007\/s10803-021-05154-x","volume":"52","author":"A Lischke","year":"2022","unstructured":"Lischke, A., Freyberger, H. J., Grabe, H. J., Mau-Moeller, A. & Pahnke, R. Alexithymic but not autistic traits impair prosocial behavior. J. Autism Dev. Disord. 52, 2794\u20132800 (2022).","journal-title":"J. Autism Dev. Disord"},{"key":"8423_CR82","unstructured":"Taylor, G. J., Bagby, R. M. & Parker, J. D. A. Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness (Cambridge University Press, 1999)."},{"key":"8423_CR83","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.jpsychores.2018.10.003","volume":"115","author":"J Klinger-K\u00f6nig","year":"2018","unstructured":"Klinger-K\u00f6nig, J. et al. Predicting physical and mental health symptoms: additive and interactive effects of difficulty identifying feelings, neuroticism and extraversion. J. Psychosom. Res. 115, 14\u201323 (2018).","journal-title":"J. Psychosom. Res."},{"key":"8423_CR84","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.psychres.2015.02.006","volume":"227","author":"S Li","year":"2015","unstructured":"Li, S., Zhang, B., Guo, Y. & Zhang, J. The association between alexithymia as assessed by the 20-item Toronto alexithymia scale and depression: A meta-analysis. Psychiatry Res. 227, 1\u20139 (2015).","journal-title":"Psychiatry Res."},{"key":"8423_CR85","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.jad.2021.10.029","volume":"297","author":"F Bordalo","year":"2022","unstructured":"Bordalo, F. & Carvalho, I. P. The role of alexithymia as a risk factor for self-harm among adolescents in depression - a systematic review. J. Affect. Disord. 297, 130\u2013144 (2022).","journal-title":"J. Affect. Disord"},{"key":"8423_CR86","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.jpsychires.2023.04.006","volume":"162","author":"Z Dong","year":"2023","unstructured":"Dong, Z. et al. Association between alexithymia and non-suicidal self-injury in psychiatric patients: the mediating role of self-esteem and the moderating role of emotional intelligence. J. Psychiatr Res. 162, 57\u201364 (2023).","journal-title":"J. Psychiatr Res."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-08423-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-08423-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-08423-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T11:02:08Z","timestamp":1751799728000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-08423-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,2]]},"references-count":86,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["8423"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-08423-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,2]]},"assertion":[{"value":"19 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23097"}}