In recent years, the mental health challenges faced by adolescents have escalated into a global public health concern. Two behaviors in particular—non-suicidal self-injury (NSSI) and internet addiction (IA)—have garnered significant attention due to their complex relationship with mood disorders. A groundbreaking study published in BMC Psychiatry in 2025 delves deep into this association, utilizing advanced network analysis techniques to untangle how depressive and anxiety symptoms interplay with these maladaptive behaviors in a population of Chinese adolescents.
The research team led by Ma, Xiao, and Ou recruited 1,799 adolescents aged between 12 and 16 years from Chinese schools, employing a battery of self-report questionnaires designed to capture a multifaceted picture of mental health symptoms and behavioral tendencies. What sets this study apart is its methodological approach: by applying conditional independence testing coupled with partial correlation networks and direct acyclic graphs, the investigators could dissect the nuanced interdependencies among NSSI, IA, and distinct symptoms of depression and anxiety measured via the PHQ-9 and GAD-7 scales.
One of the most striking revelations in this research is that internet addiction and non-suicidal self-injury are not directly correlated when controlling for underlying depressive and anxiety symptoms. This finding contradicts prior assumptions that these behaviors might inherently exacerbate or trigger each other. Instead, the study suggests that the apparent overlap in these behaviors could be more accurately attributed to their shared association with emotional symptoms rather than a causal link between IA and NSSI themselves.
Delving deeper into symptom-specific relationships, the analysis illuminated that internet addiction showed a stronger affinity with anxiety rather than depression. Symptoms such as restlessness, which is often a hallmark of anxiety disorders, emerged as a central node causally linked to IA behaviors. This insight advances our understanding of how certain physiological and psychological states characterize the compulsive engagement with digital media, possibly as an attempt to self-soothe or temporarily escape distress.
Conversely, non-suicidal self-injury exhibited connections to both anxiety and depression symptoms. Particularly, suicidal ideation and fear (“afraid”) were identified as key drivers causally linked to NSSI within the network model. This not only underscores the critical clinical importance of these symptoms in adolescents indulging in self-harm but also points towards potential psychological mechanisms—possibly involving hopelessness and heightened threat perception—that require targeted intervention.
The analytical rigor of constructing direct acyclic graphs allowed the researchers to speculate on causal pathways rather than mere associations, a methodological advantage that provides clarity to intervention strategies. For instance, addressing restlessness-related anxiety symptoms might reduce the risk or severity of internet addiction, whereas therapeutically focusing on suicidal ideation and associated fears could more effectively mitigate NSSI behaviors.
From a developmental psychiatry perspective, the conditional independence of NSSI and IA after accounting for mood symptoms challenges traditional treatment paradigms. Rather than addressing NSSI and IA as directly linked phenomena, mental health professionals might need to conceptualize them as parallel manifestations of underlying emotional dysregulation with distinct symptom-specific drivers.
This study has potent implications for public health policies and school-based mental health programs in China and beyond. The focus on symptom-level interventions—rather than categorical diagnoses alone—could foster more personalized treatment models. It could also help in resource allocation, ensuring preventive strategies are directed toward the most impactful symptom domains such as suicidal ideation, fear, and restlessness.
Given the massive proliferation of internet usage among today’s youth, understanding the psychological stakes entwined with digital behaviors is vital. The finding that IA is primarily linked to anxiety symptoms highlights that excessive internet use in teenagers might be less about behavioral addiction per se and more about a maladaptive coping mechanism for anxiety, warranting nuanced clinical assessments.
Equally critical is the study’s identification of suicidal ideation—not just self-injury—as a central symptom tied to NSSI. This nexus could serve as an early warning system, where intensified suicidal thoughts propel harmful coping behaviors. Addressing these thoughts through targeted cognitive-behavioral or dialectical approaches might reduce the incidence or severity of NSSI.
Moreover, the methodological innovation showcased in this study exemplifies the power of network analysis for mental health research. By breaking down psychiatric conditions into symptom-symptom interactions, researchers can transcend traditional diagnostic boundaries and glean the true architecture of psychopathological phenomena in adolescent populations.
As understanding grows about how emotional symptoms underpin risky behaviors, the study calls for integrative approaches in clinical practice. Mental health clinicians should be equipped not only to recognize symptom clusters but also to intervene at these critical junctures to prevent progression into full-blown psychiatric disorders or entrenched maladaptive patterns.
In conclusion, Ma and colleagues have charted a new path in adolescent mental health research. Their study reveals that internet addiction and non-suicidal self-injury, while often grouped together as adolescent risk behaviors, operate through separate but interrelated emotional symptom networks. The targeting of suicidal ideation, fear, and restlessness promises to refine therapeutic strategies and mitigate these behaviors’ detrimental effects on adolescent well-being. This research adds a vital piece to the complex puzzle of youth mental health in the digital era and sets the stage for future longitudinal studies to track causality and treatment outcomes.
Subject of Research: Associations between internet addiction, non-suicidal self-injury, and depression-anxiety symptoms in Chinese adolescent students using network analysis
Article Title: Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students – a network analysis
Article References:
Ma, M., Xiao, C., Ou, W. et al. Depression and anxiety symptoms associated with internet addiction and non-suicidal self-injury in Chinese adolescent students – a network analysis. BMC Psychiatry 25, 731 (2025). https://doi.org/10.1186/s12888-025-07131-5
Image Credits: AI Generated
