Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students - a network analysis

Abstract Background Non-suicidal self-injury (NSSI) and Internet addiction (IA) are adolescent maladaptive behaviors that are receiving increasing attention and exerting a significant impact on both adolescent development and public health, and depressive and anxiety symptoms are two of the most ass...

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Main Authors: Mohan Ma, Chuman Xiao, Wenwen Ou, Xiaoshu Li, Yumeng Yang, Yafei Chen, Chunxi Ke, Jin Liu, Bangshan Liu, Yunjing Li, Siqi Yang, Yimei Lu, Liang Li, Guanyi Lv, Xiaotian Zhao, Yaqi Qin, Mi Wang, Qiyuan Wang, Yan Zhang, Yumeng Ju
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-07131-5
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author Mohan Ma
Chuman Xiao
Wenwen Ou
Xiaoshu Li
Yumeng Yang
Yafei Chen
Chunxi Ke
Jin Liu
Bangshan Liu
Yunjing Li
Siqi Yang
Yimei Lu
Liang Li
Guanyi Lv
Xiaotian Zhao
Yaqi Qin
Mi Wang
Qiyuan Wang
Yan Zhang
Yumeng Ju
author_facet Mohan Ma
Chuman Xiao
Wenwen Ou
Xiaoshu Li
Yumeng Yang
Yafei Chen
Chunxi Ke
Jin Liu
Bangshan Liu
Yunjing Li
Siqi Yang
Yimei Lu
Liang Li
Guanyi Lv
Xiaotian Zhao
Yaqi Qin
Mi Wang
Qiyuan Wang
Yan Zhang
Yumeng Ju
author_sort Mohan Ma
collection DOAJ
description Abstract Background Non-suicidal self-injury (NSSI) and Internet addiction (IA) are adolescent maladaptive behaviors that are receiving increasing attention and exerting a significant impact on both adolescent development and public health, and depressive and anxiety symptoms are two of the most associated risk factors of NSSI and IA. This study aimed to use network analysis to explore the associations between NSSI, IA, and depression-anxiety symptoms. Methods A total of 1799 adolescents aged 12–16 completed self-report questionnaires. We conducted a conditional independence test on NSSI and IA controlling for depression and anxiety, and constructed a partial correlation network and a direct acyclic graph incorporating NSSI, IA, nine depressive symptoms (from PHQ-9), and seven anxiety symptoms (from GAD-7). Results Results suggested that there was no significant correlation between NSSI and IA after controlling for depression (P = 0.25) and anxiety (P = 0.14) symptoms. IA was mainly associated with Anxiety symptoms, and NSSI was associated with both anxiety and depressive symptoms. Suicidal ideation and afraid were causally related to NSSI, and restlessness was causally related to IA. Conclusions This study suggests that NSSI and IA are conditionally independent of depression and anxiety. Specific symptoms including suicidal ideation, afraid, and restlessness are the key intervention targets of NSSI and IA behaviors.
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spelling doaj-art-7a351a96e5a945b8b841c58af5cda9572025-08-20T03:43:29ZengBMCBMC Psychiatry1471-244X2025-07-0125111210.1186/s12888-025-07131-5Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students - a network analysisMohan Ma0Chuman Xiao1Wenwen Ou2Xiaoshu Li3Yumeng Yang4Yafei Chen5Chunxi Ke6Jin Liu7Bangshan Liu8Yunjing Li9Siqi Yang10Yimei Lu11Liang Li12Guanyi Lv13Xiaotian Zhao14Yaqi Qin15Mi Wang16Qiyuan Wang17Yan Zhang18Yumeng Ju19Department of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityXiangya Medical School, The Second Xiangya Hospital, Central South UniversityXiangya Medical School, The Second Xiangya Hospital, Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Mental Health Center, Xiangya Hospital, Central South UniversityDepartment of Emergency Medicine, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityAbstract Background Non-suicidal self-injury (NSSI) and Internet addiction (IA) are adolescent maladaptive behaviors that are receiving increasing attention and exerting a significant impact on both adolescent development and public health, and depressive and anxiety symptoms are two of the most associated risk factors of NSSI and IA. This study aimed to use network analysis to explore the associations between NSSI, IA, and depression-anxiety symptoms. Methods A total of 1799 adolescents aged 12–16 completed self-report questionnaires. We conducted a conditional independence test on NSSI and IA controlling for depression and anxiety, and constructed a partial correlation network and a direct acyclic graph incorporating NSSI, IA, nine depressive symptoms (from PHQ-9), and seven anxiety symptoms (from GAD-7). Results Results suggested that there was no significant correlation between NSSI and IA after controlling for depression (P = 0.25) and anxiety (P = 0.14) symptoms. IA was mainly associated with Anxiety symptoms, and NSSI was associated with both anxiety and depressive symptoms. Suicidal ideation and afraid were causally related to NSSI, and restlessness was causally related to IA. Conclusions This study suggests that NSSI and IA are conditionally independent of depression and anxiety. Specific symptoms including suicidal ideation, afraid, and restlessness are the key intervention targets of NSSI and IA behaviors.https://doi.org/10.1186/s12888-025-07131-5Non-suicidal self-injuryInternet addictionNetwork analysisBayesian networkDepressionAnxiety
spellingShingle Mohan Ma
Chuman Xiao
Wenwen Ou
Xiaoshu Li
Yumeng Yang
Yafei Chen
Chunxi Ke
Jin Liu
Bangshan Liu
Yunjing Li
Siqi Yang
Yimei Lu
Liang Li
Guanyi Lv
Xiaotian Zhao
Yaqi Qin
Mi Wang
Qiyuan Wang
Yan Zhang
Yumeng Ju
Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students - a network analysis
BMC Psychiatry
Non-suicidal self-injury
Internet addiction
Network analysis
Bayesian network
Depression
Anxiety
title Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students - a network analysis
title_full Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students - a network analysis
title_fullStr Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students - a network analysis
title_full_unstemmed Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students - a network analysis
title_short Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students - a network analysis
title_sort depression and anxiety symptoms associated with internet addiction and non suicidal self injury in chinese adolescent students a network analysis
topic Non-suicidal self-injury
Internet addiction
Network analysis
Bayesian network
Depression
Anxiety
url https://doi.org/10.1186/s12888-025-07131-5
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