The Impact of Adverse Childhood Experiences on Non-Suicidal Self-Injury Among Korean Adolescents: Moderating Effects of Social Support and Risk Profiling of Vulnerable Subgroups

Purpose: This study examined the prevalence of non-suicidal self-injury(NSSI) among Korean adolescents and investigated the independent and interactive associations of adverse childhood experiences(ACEs) and social support with NSSI. Methods: Data from a descriptive cross-sectional survey of Korean adolescents were analyzed. Group differences based on NSSI status were evaluated using χ²-test or independent t-test. Hierarchical multiple logistic regression analysis was performed to determine the independent effects of ACEs and social support on NSSI, and to test whether social support moderated the relationship between ACEs and NSSI. Results: Over one-third of the participants reported a past-year history of NSSI. Cumulative ACEs were independently associated with higher odds of NSSI, whereas higher social support was independently associated with lower odds of NSSI, confirming its robust protective role. However, the interaction between ACEs and social support was not statistically significant, indicating that social support exerts a generalized protective effect rather than selectively moderating the association between ACE exposure and NSSI.Conclusion: These findings underscore the need for systemic, early mental health screening within school and community settings that comprehensively assesses ACEs, depressive symptoms, and self-injury risk. Furthermore, prevention strategies should prioritize multi-source support networks involving peers, educators, and professional counselors, alongside evidence-based interventions tailored to enhance emotion regulation and resilience.