Linking Emotional Prosody Perception to Suicidal Ideation Through Emotion Dysregulation in Chinese Adolescents and Young Adults with Non-Suicidal Self-Injury

OBJECTIVE: Nonsuicidal self-injury (NSSI) commonly serves emotion-regulation and interpersonal functions. Although emotion recognition is integral to emotion regulation, speech emotion recognition (SER) in NSSI remains understudied. We examined SER and its associations with emotion dysregulation, NSSI severity, and suicidal ideation. METHODS: Participants were 392 college students aged 18-25 years, including 296 with NSSI and 96 healthy controls. Recognition accuracy, confusion patterns, perceived intensity, and arousal were assessed across seven emotions and three stimulus types. Group differences were examined using aligned rank transform mixed-effects ANOVAs. Within the NSSI group, sparse partial least squares regression examined multivariate associations between 63 SER features and five dimensions of emotion-regulation difficulties. Partial correlations were conducted to examine the clinical relevance of the sPLS-derived profiles to NSSI severity and suicidal ideation. RESULTS: The groups did not differ in recognition accuracy or global confusion patterns. The NSSI group reported higher arousal across all emotion categories. One significant sPLS component explained 27.7% of the covariance between SER and emotion-regulation features. Fear and anger intensity and arousal and disgust-to-neutral misclassification contributed most strongly to the SER profile, which was associated with all five emotion-regulation dimensions. After adjustment, the emotion-regulation component remained associated with suicidal ideation but not NSSI severity, whereas the SER component was not directly associated with either outcome. CONCLUSIONS: NSSI was characterized by heightened emotional reactivity rather than generalized emotion-recognition impairment. SER-related responses to fear and anger were associated with broad emotion-regulation difficulties, which were further related to suicidal ideation.