Mediated Pathways to Self-harm: Personality Organization, Emotion Regulation, and the Impact of Adolescent Cybervictimization

Background: Adolescent self-harm is an escalating public health issue, frequently associated with challenges in personality organization and exposure to cyberbullying. Objectives: This study examines the direct and indirect relationships among personality organization, cyber-victimization, and self-harm behaviors in adolescents, emphasizing the mediating role of emotion regulation difficulties. Methods: Utilizing a descriptive correlational design, we employed multi-stage cluster random sampling to recruit 356 adolescents (65.17% female, 34.83% male) from Tehran in 2024. Data were gathered using validated instruments: The Self-harm Behavior Questionnaire, Personality Organization Questionnaire, Difficulties in Emotion Regulation Scale-Short Form, and Cyber-victimization Scale. Structural equation modeling (SEM) was performed using AMOS software to explore variable relationships. Results: The results indicated significant positive associations between personality organization (primitive psychological defenses: 24.76 ± 6.33; identity diffusion: 22.92 ± 5.14; reality testing: 40.46 ± 9.79, cyberbullying (cyber aggression: 15.41 ± 4.10); cyber victimization: 16.96 ± 4.18, and self-harm behaviors: 6.06 ± 1.88 (all P < 0.001). Emotion regulation difficulties (e.g., lack of clarity: 6.77 ± 2.49); non-acceptance: 9.41 ± 2.92 significantly mediated the relationships between personality organization, cyberbullying, and self-harm (P < 0.001). Conclusions: These findings highlight that compromised personality organization and cyber-victimization are strong predictors of self-harm, with emotion regulation difficulties acting as a crucial mediator. Interventions focused on enhancing emotion regulation skills may reduce the risk of self-harm in adolescents, presenting a promising strategy for prevention and support.