{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T19:14:37Z","timestamp":1779390877698,"version":"3.53.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Self-harm has become a significant and increasing global problem in children and adolescents. In this study, we tested a moderated mediation model to examine the impact of study pressure and depression, and one protective factor, good parent-child relationship, on self harm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A self-report Questionnaire survey was conducted among 33,285 primary school students from 3rd-6th grade (mean age = 10.36 years, SD = 1.24, 51.7% girls) in Shapingba District Chongqing, China. The survey assessed study pressure, depression, parent-child relationship, and self harm behaviors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The reporting rates of self-harm and depression in grades 3-6 of primary school were 12.7% and 16.3%, respectively. Both moderate and high study pressure were significantly associated with an increased risk of self-harm, with depression acting as a mediator (indirect effects: moderate study pressure = 0.045, high study pressure = 0.125, p &amp;lt; 0.001). Furthermore, a good parent-child relationship weakened the association between study pressure and self-harm, thus self harm on moderate study pressure (\u03b2=-0.057) and on high study pressure (\u03b2=-0.032) are lower than those without the moderator of a good parent-child relationship(\u03b2=0.116; \u03b2=0.168), as well as between study pressure and depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study is the first to conduct a self-harm survey in the largest population-based sample of Chinese primary school students. The results highlight the importance of monitoring study pressure, fostering a positive parent-child relationship, and managing depressive symptoms to support students\u2019 mental health. These findings enhance our understanding of the development of self-harm behaviors and can inform the design of targeted intervention programs aimed at reducing self-harm among primary school students.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1580527","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T09:54:58Z","timestamp":1746006898000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Study pressure and self harm in Chinese primary school students: the effect of depression and parent-child 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