Non-suicidal self-injury (NSSI) is common among adolescents. Although many studies has established a robust association between insomnia and NSSI in adolescents, the psychological mechanisms linking insomnia to NSSI remain insufficiently explored. This study aims to investigate the association between insomnia and NSSI, focusing on the mediating role of emotion regulation and the moderating effect of mindfulness. A cross-sectional survey was conducted among 4,040 students at a vocational and technical school in China. Participants were stratified into two groups based on the presence or absence of NSSI behaviors within the past year. Demographic data and standardized assessments were collected, including the Insomnia Severity Index (ISI), Difficulties in Emotion Regulation Scale (DERS), Mindful Attention Awareness Scale (MAAS), and the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire (ANSAQ). Structural equation modeling (SEM) was used to test hypothesized relationships. Among the participants, 34.7% ( n = 1,402) reported NSSI in the past year. Those with NSSI showed significantly higher insomnia severity, greater emotion dysregulation, and lower mindfulness (all p < 0.01). Path analysis showed that insomnia was indirectly associated with NSSI through emotion regulation difficulties ( p < 0.01). This indirect association is moderated by mindfulness. At higher levels of mindfulness, the indirect effect was smaller (Indirect = 0.155, p < 0.01), whereas at lower levels of mindfulness, the indirect effect was larger (Indirect = 0.198, p < 0.01). Emotion regulation significantly mediated the association between sleep problems and NSSI, and this pathway was moderated by mindfulness, the mediating effect was stronger at lower levels of mindfulness and weaker at higher levels.
Li et al. (Sat,) studied this question.
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