Recently, a research team led by Associate Professor Yanhong Zhang from the Nursing Department of Affiliated Brain Hospital of Nanjing Medical University (NMU) published an original research paper entitled "Why do adolescents hurt themselves? A qualitative study" in the International Journal of Nursing Studies (IJNS), a leading international journal in the field of nursing. According to the latest Chinese Academy of Sciences journal ranking, IJNS is classified as a Top Q1 journal in the medical sciences and Q1 in the nursing subcategory, with an SCI impact factor of 7.1, ranking first among nursing journals worldwide.
Non-suicidal self-injury (NSSI) is relatively common among adolescents with mood disorders. This behavior not only poses serious threats to adolescents’ physical and mental health but also places a heavy burden on their families. In psychiatric medical institutions, nursing professionals frequently experience negative emotions and occupational burnout while caring for adolescents engaging in NSSI. Gaining a deeper understanding of the underlying motivations for adolescent self-injury remains a critical challenge for clinical practitioners.
This study adopted an exploratory qualitative design. From January 2024 to January 2025, semi-structured interviews were conducted with 18 adolescents with mood disorders and a history of NSSI, recruited from a tertiary psychiatric hospital. Guided by the "Benefits and Barriers Model," the study focused on adolescents’ perceived benefits of self-injury, behavioral barriers, and related contextual factors, as well as their dynamic interplay, with particular attention to cultural associations. Data were analyzed using reflective thematic analysis.
The findings revealed that adolescents' perceived benefits of NSSI mainly manifested in three areas: the release of negative emotions, pleasurable experiences following stress relief, and the alleviation of interpersonal communication barriers. Perceived barriers primarily included insufficient internal psychological resources, a lack of external emotional support, and constraints imposed by social norms. Key contextual factors involved emotional states, the quality of parent-child relationships, social adaptation strategies, and engagement in online communities, all of which interacted with the aforementioned benefits and barriers. In addition, the study identified a highly competitive academic environment, changes and emotional insecurity within parent-child relationships, and cultural traditions emphasizing introspection and emotional restraint as constituting a distinctive socio-cultural context influencing NSSI.
This study, grounded in the authentic experiences of participants, provides an important theoretical foundation for reducing the risk of self-injury among adolescents. The findings suggest that nursing professionals should implement culturally adaptive and systematic nursing interventions, promoting adolescents' emotional regulation capacities, interpersonal trust, and environmental support at the individual, family, and societal levels.
Associate Professor Yanhong Zhang from the Nursing Department of the Affiliated Brain Hospital of NMU is the sole corresponding author, and Xin Wang, Deputy Chief Nurse, is the first author of the paper. This study was supported by the Nanjing Municipal Health Commission Research Project (Grant No: YKK23142).
(Drafted by Yanhong Zhang’s research team; Reviewed by Qin Xu; Translation revised by Bei Zhang)
