The Mediating Effects of Depression and Anxiety and the Moderated Mediating Effects of Social Support in Relationship Between Academic Stress and Non-suicidal-injury in High school students

Objectives This study aims to reduce and prevent non-suicidal self-injury in adolescents by verifying the mediating effects of depression and anxiety and the moderated mediating effects of social support in the relationship between academic stress and non-suicidal self-injury in High school students. Methods Academic stress, depression, anxiety, non-suicidal self-injury, and social support were measured among 383 students who agreed to participate in the study, out of a total of 500 high school students from five high schools and one college preparatory academy located in Daegu, Pohang, and Ulsan.. Frequency analysis, reliability analysis (Cronbach’ α), descriptive statistics, correlation analysis, and confirmatory factor analysis (CFA) were conducted with 195 students who responded that they had experienced non-suicidal self-injury among the foregoing 383 high school students using SPSS 29.0 and AMOS 28.0. Structural model analysis was conducted to identify each pathway, mediation model analysis was conducted to identify the mediating effects of depression and anxiety, and multi-group analysis was conducted to identify the moderated mediating effects of social support. Results First, in the relationship between academic stress and non-suicidal self-injury, no single mediating effect of depression and anxiety appeared, and the sequential double mediating effects of depression and anxiety were significant. Second, in the relationship between academic stress and non-suicidal self-injury, social support moderated the effect of anxiety on non-suicidal self-injury. Third, in the structural relationship between academic stress, depression, anxiety, and non-suicidal self-injury, the moderated mediating effect of social support was significant in the single mediation pathway of anxiety and the double mediation pathway of depression and anxiety. Conclusions It was verified that anxiety emotion was a risk factor and social support was a protective factor and moderating factor in the relationship between academic stress and non-suicidal self-injury in adolescents. This suggests that various measures that can reduce adolescents’ anxiety and expand social support are necessary to reduce and prevent non-suicidal self-injury due to academic stress in adolescents.