The mediating roles of anxiety, loneliness, stress, and depression in the relationship between cyberbullying and non-suicidal self-injury: propensity score matching and causal mediation analysis

Abstract

Background

Non-suicidal self-injury (NSSI) not only causes direct physical harm but also severely impacts mental health, increasing the risks of psychological disorders, behavioral issues, and suicidal tendencies. With the widespread use of the internet and electronic communication tools on smartphones, such as social media and instant messaging applications, cyberbullying has become increasingly prevalent. However, research on the relationship between cyberbullying and NSSI remains relatively limited at present.

Methods

This research was conducted in Nantong City, Jiangsu Province, from July to September 2024, utilizing a convenience sampling method with 1,751 participants. Propensity Score Matching (PSM) was employed to control for confounding factors, while causal mediation analysis was used to assess the mediating effects of anxiety, depression, stress, and loneliness between cyberbullying and NSSI.

Results

In this study, 557 participants (31.8%) reported having experienced cyberbullying, Cyberbullying significantly increases NSSI odds through direct and indirect effects, mediated by anxiety (ACME = 0.08, ADE = 0.22, mediated proportion = 0.28), loneliness (ACME = 0.04, ADE = 0.26, mediated proportion = 0.14), stress (ACME = 0.05, ADE = 0.24, mediated proportion = 0.18), and depression (ACME = 0.06, ADE = 0.24, mediated proportion = 0.19).

Conclusion

This study explores the relationship between cyberbullying, mental health issues (depression, anxiety, stress, loneliness), and NSSI. Findings show cyberbullying directly and indirectly increases NSSI risk, with loneliness as a key mediator. Despite insights, the study has limitations, suggesting a need for more rigorous designs and comprehensive data.