The interplay among nonsuicidal self-injury, depression, loneliness, resilience, and family relationships in youth: A path analysis

Background: Recent research has increasingly highlighted the complex interplay among depression, loneliness, and non-suicidal self-injury (NSSI). Resilience and family relationships have emerged as potential protective factors in mitigating these mental health challenges. Methods: This study investigated the associations among depression, loneliness, NSSI, resilience, and family relationships in a sample of 7146 Italian high school and university students. Participants completed a multidimensional online survey featuring standardized instruments to assess depressive symptoms, loneliness and resilience. Spearman correlations and path analysis were employed to examine the interrelationships among these variables. Results: A substantial proportion of participants reported clinically significant depressive symptoms (42.8 %) and NSSI behaviours (28.4 %). Path analysis revealed a strong positive effect of depressive symptoms on both loneliness and NSSI, alongside a pronounced negative effect on satisfaction with family relationships and resilience. Loneliness significantly reduced satisfaction with family relationships and resilience, while the impact on NSSI was significant, but minimal. Family relationships exhibited a significant but modest negative effect on NSSI behaviours. Limitations: The generalizability of the sample and the potential biases inherent in self-report measures are addressed. Conclusions: This study highlights the intricate interplay between depressive symptoms, loneliness, NSSI, resilience, and family relationships in a large sample of Italian adolescents and young adults. The findings emphasize the need for comprehensive interventions targeting these factors to enhance mental health and well-being.