Journal of Affective Disorders 345 (2024) 85–93

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Journal of Affective Disorders

journal homepage: www.elsevier.com/locate/jad

Research paper

Self-esteem buffers the stress sensitizing effect of childhood maltreatment

on adolescent nonsuicidal self-injury
Yemiao Gao a, Chunxi Liang a, Xia Liu a, *, Rong Bai a, Shufen Xing b
a
Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
b
School of Psychology, Capital Normal University, Beijing, China

A R T I C L E I N F O A B S T R A C T

Keywords: Background: Adversity in childhood increases the risk of psychopathology, perhaps by influencing sensitivity to
Child maltreatment recent stressful life events (SLEs). However, little is known about the stress-sensitizing effect of childhood
Dependent stressful life events adversity on nonsuicidal self-injury (NSSI), whether stress sensitization exists in specific types of SLEs, and the
Nonsuicidal self-injury
stress-buffering effect of self-esteem. This study aimed to investigate whether exposure to child maltreatment
Self-esteem
increases adolescent's vulnerability to the effects of dependent and independent SLEs on later NSSI and whether
Stress sensitization
self-esteem buffers this risk.
Methods: We conducted a two-wave study with 18-month intervals. 601 Chinese adolescents completed self-
report measures of child maltreatment, SLEs, self-esteem, and NSSI.
Results: Results supported the stress sensitization hypothesis for child maltreatment regarding dependent SLEs,
with dependent SLEs significantly predicting later NSSI only in maltreated adolescents. Moreover, self-esteem
buffered the relationship between dependent SLEs and NSSI in maltreated adolescents but amplified the rela­
tionship in non-maltreated adolescents. In the maltreated group, dependent SLEs predicted increased NSSI only
in those with low self-esteem. In contrast, in the control group, dependent SLEs were significantly associated with
NSSI in individuals with high self-esteem.
Limitations: We did not collect information on the timing of exposure to child maltreatment. Future studies that
assess child maltreatment during critical periods of development may be able to identify sensitive period in
which maltreatment sensitizes individuals to stress in adolescents.
Conclusion: Findings provide preliminary evidence that child maltreatment has a stress-sensitizing effect on
adolescent NSSI. Improving self-esteem may mitigate the associations between SLEs and NSSI in adolescents
exposed to child maltreatment.

1. Introduction 1.1. Stress-sensitizing effect of child maltreatment on NSSI

Nonsuicidal self-injury (NSSI) is defined as deliberate and direct self-
inflicted damage of body tissues without intent to die (Nock, 2009). In
addition to the physical injury and distress related to NSSI itself, NSSI
increases risk for future suicide attempts (Ribeiro et al., 2016). Notably,
NSSI typically occurs and peaks during adolescence, with the 12-month
incidence rates of adolescents ranging from 13.3 % to 27.6 % globally
(Lim et al., 2019) and 17.0 % to 29.2 % among Chinese adolescents
(Tang et al., 2018). Given the high prevalence and serious consequences
of NSSI in adolescence, studies examining the mechanisms by which risk
and protective factors influence NSSI may have important conceptual
and intervention implications.
There is considerable evidence indicating that stressful life events
(SLEs), which include mild to severe negative life incidents and daily
hassles that occurred in a recent period of time (e.g., within the past
year) (Moya-Higueras et al., 2020), are consistently linked to increased
NSSI (MacKin et al., 2017; Mo et al., 2019). This association is partic­
ularly pronounced among adolescents, a developmental stage known for
heightened susceptibility to stress (Andersen and Teicher, 2008).
However, not all adolescents with experiences of SLEs develop NSSI.
One hypothesis to explain this heterogeneity is that childhood adversity
increases individuals' sensitivity to the negative effects of later SLEs. In
other words, experiences of childhood adversity may reduce an

* Corresponding author at: Institute of Developmental Psychology, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China.
E-mail address: liuxia@bnu.edu.cn (X. Liu).

https://doi.org/10.1016/j.jad.2023.10.117
Received 1 April 2023; Received in revised form 10 September 2023; Accepted 15 October 2023
Available online 20 October 2023
0165-0327/© 2023 Elsevier B.V. All rights reserved.
Y. Gao et al.
individual's tolerance for future stressful events that trigger mental
health problems or exacerbate underlying vulnerabilities. This
assumption is in line with Nock's (2009) integrated theoretical model of
NSSI, which underscores the role of distal and proximal risk factors in
jointly increasing an individual's vulnerability to NSSI, suggesting that
childhood adversity may interfere with adolescents' responses to daily
stressors.
Child maltreatment is a well-established risk factor for NSSI in
adolescence (Babcock Fenerci et al., 2022). The Adaptive Calibration
Model posits that child maltreatment, as a common form of childhood
adversity, can lead to individual differences in stress sensitivity and
responsivity (Del Giudice et al., 2011). Previous studies have found that
child maltreatment facilitated the development of maladaptive schemas
and vulnerability to severe affect dysregulation in response to daily
stressors, which increased the likelihood of adolescents to engage in
NSSI for a range of intrapersonal and interpersonal functions driven by
their distress (Mahtani et al., 2019). Therefore, adolescents with a his­
tory of child maltreatment may be at higher risk of developing NSSI at a
low level of daily stress, as compared to those without such a history.
Despite the fact that this pattern of stress sensitization has been docu­
mented across several studies in depression, externalizing problems, and
post-traumatic stress disorders (Espejo et al., 2007; McLaughlin et al.,
2017; Wade et al., 2019), limited research has explored the stress-
sensitizing effect for adolescent NSSI. Since daily stress is believed to
play a critical role in the risk for NSSI during adolescence (Liu et al.,
2014), it is important to develop an understanding on whether the
relationship between SLEs and adolescent NSSI is sensitized by
maltreatment histories. Thus, the first aim of the current study is to
examine whether a similar pattern of stress sensitization of child
maltreatment is observed for adolescent NSSI.
1.2. Dependent and independent life events
When examining the associations between SLEs and adolescent
psychopathology, recent research highlights the importance of consid­
ering the heterogeneity of SLEs. SLEs can be divided into dependent and
independent events. Dependent events are those whose occurrence is at
least partially controllable or influenced by the individual (e.g., getting
fights with friends), whereas independent events are those that are
beyond the individual's control (e.g., death of a family member) (Wade
et al., 2022). Prior work has provided mixed results with respect to
whether stress sensitization is stronger for independent versus depen­
dent SLEs in relation to psychopathology. For instance, Shapero et al.
(2014) found that childhood adversity only sensitized youths to
dependent SLEs, not to independent SLEs. Moreover, there is evidence
indicating that dependent SLEs exhibit a stronger association with
mental health problems in adolescents than independent SLEs (Fassett-
Carman et al., 2019; Jhang, 2020). For example, Fassett-Carman et al.
(2019) found that dependent SLEs occurring within the past 6 months
were associated with depression and anxiety symptoms in adolescents in
the recent 2 weeks. In a longitudinal study, Jhang (2020) also found that
dependent SLEs increased the severity of mental health problems of
adolescents during the four-year period, whereas independent events
did not. However, other studies have shown that stress sensitization
might be more pronounced for independent SLEs when considering
depression and externalizing problems (La Rocque et al., 2014; Wade
et al., 2019). For example, in Wade et al.'s (2019) study, a positive as­
sociation was observed between independent SLEs (but not dependent
SLEs) in preadolescence and externalizing problems in adolescence
among children who had experienced institutionalization, suggesting a
stress sensitization effect of child neglect for independent SLEs. Notably,
their research provided weak evidence that child neglect sensitized
children to develop externalizing problems through generating life
events, favoring the concept of stress sensitization over stress
generation.
It's worth noting that previous investigations into the relationship
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Journal of Affective Disorders 345 (2024) 85–93
between dependent versus independent SLEs and psychopathology have
focused on internalizing problems like depression and externalizing
problems. It is unclear whether dependent and independent SLEs would
show differing stress sensitization effects concerning NSSI. According to
the Defective Self Model of NSSI (Hooley et al., 2010), some individuals
engage in NSSI to gratify a desire for self-punishment. It is possible that,
compared with independent SLEs, the SLEs that are to some extent
dependent on an individual's behaviors are more likely to trigger their
self-punishment motivation, thereby increasing the risk for engaging in
NSSI among those with a maltreatment history. In support of this idea, it
has been shown that negative cognitive styles and rumination, which are
strongly linked to NSSI, have stronger relationships with dependent
versus independent SLEs (Hamilton et al., 2015). To date, there is
paucity of research taking dependent and independent SLEs simulta­
neously into consideration when examining the relations between stress
and NSSI. Therefore, as our second aim, the current study investigated
whether the stress-sensitizing effects of dependent SLEs would be
stronger than those of independent SLEs in relation to adolescent NSSI.
1.3. Stress-buffering effect of self-esteem on NSSI
Despite increased awareness of potential mechanisms linking envi­
ronmental risk factors and NSSI, few evidence-based prevention pro­
grams or treatments have been designed for NSSI. Intrapersonal factors
protecting individuals from engaging NSSI are supposed to be great
targets of prevention and treatment. The Benefits and Barriers Model of
NSSI (Hooley and Franklin, 2018) emphasized the protecting role of
positive self-view in NSSI engagement. Self-esteem, defined as positive
self-evaluations or one's appraisals of his or her value (Leary and Bau­
meister, 2000), has demonstrated strong relationship with NSSI (Meng
et al., 2022). Additionally, self-esteem has been found to be associated
with one's abilities to deal with daily stress (Pulopulos et al., 2022).
According to the self-esteem buffering hypothesis (Orth et al., 2009),
individuals with high self-esteem are assumed to have more coping re­
sources when they encounter stressful events. However, inconsistent
with previous research linking greater impact of stress on maladjust­
ment with low self-esteem (Ho et al., 2022; Zheng et al., 2020), several
recent studies among children and youths have found that those with
higher self-esteem received stronger impact from life stressors (Xu et al.,
2018; Yuan et al., 2022). Given the fact that research about the stress-
buffering effect of self-esteem in maltreated adolescents is scarce, it
remains unclear whether self-esteem have different protecting effects on
relationships between SLEs and NSSI in adolescents with or without a
history of child maltreatment.
1.4. The current study
The current study used a longitudinal design to investigate whether
child maltreatment experiences sensitize adolescents to the effects of
current stressful life events on NSSI. Given the relative evidence for
different stress sensitization with respect to dependent and independent
SLEs, we tested the effects of dependent and independent SLEs sepa­
rately. We also examined the stress-buffering effect of self-esteem among
adolescents with or without a history of maltreatment. We hypothesized
that the effects of SLEs on NSSI would be greater for adolescents with a
history of child maltreatment. Given that NSSI is suggested to be more
associated with stressful events involving oneself, we expected that the
stress-sensitization would be stronger for dependent life events. Addi­
tionally, we hypothesized that self-esteem would have different stress-
buffering effects among adolescents with or without a history of child
maltreatment, and the moderating effect of self-esteem would be
stronger for dependent life events.
Y. Gao et al.
2. Method
2.1. Participants and procedures
The participants in the current study were recruited as part of a
larger longitudinal study. 601 adolescents (51.1 % females) aged be­
tween 12 and 17 years old (M = 13.55 years, SD = 0.85) participated the
first assessment in Grade 7, and 569 adolescents completed the outcome
measures 18 months later in Grade 9. Of these participants, 546 pro­
vided complete data and were included in the final sample. Between the
final sample and those who did not participate in the Grade 9 data
collection or who had incomplete data, there were no statistically sig­
nificant differences in the main variables or age, |t|(df = 595–599) =
0.32–1.84, ps > 0.05. However, missing participants were more likely to
be males than females χ 2(df = 1) = 3.88, p = 0.049. In the current
sample, about 93 % of the mothers and fathers had an education of ju­
nior high school or less, and the others had an education of high school,
university undergraduate, or graduate.
The study was approved by the ethical board of the authors' uni­
versity. We collaborated with local educational institutions in a south­
western Chinese city to gain access to public junior high schools. Schools
within their reach for contact were invited to participate in the study,
and four agreed. We randomly selected 15 classes from Grade 7 in these
schools and invited all students in the classes to participate in the study,
with 601 students agreeing to take part. Student participation rates were
above 90 % in all classes. In each assessment, the participants were
informed of the voluntary nature of the participation and the confi­
dentiality of data. All participants provided parental and personal con­
sent before completing the questionnaires during classes. Every
participant received a gift for their participation. After the surveys, we
provided participants with contact information for local resources like
counseling services and hotlines to ensure that they knew where to seek
additional assistance if needed. We also offered them the option to
receive support from our research team if they wished to do so.
2.2. Measures
2.2.1. Child maltreatment
Adolescents' exposure to child maltreatment was measured using the
Child Trauma Questionnaire- Short Form (CTQ-SF; Bernstein et al.,
2003). CTQ-SF is widely-used screening measure of child maltreatment.
Adolescents reported on their experiences on five kinds of child
maltreatment: emotional, physical, and sexual abuse, and emotional and
physical neglect. Participants were asked to indicate the frequency of
events in their life from birth until 12 years old such as, “People in my
family hit me so hard that it left me with bruises or marks.” Responses to
the items were rated on a 5-point Likert scale (1 = never true, 5 = very
often true) and scores was summarized as an index score of exposure to a
specific form of maltreatment. In order to compare adolescents with and
without exposure to child maltreatment, a dichotomous variable of
maltreatment was computed. We categorically defined child maltreat­
ment as present when participants had experiences in any form of abuse
or neglect. Cutoff scores were as follows: emotion abuse score ≥ 13,
physical abuse score ≥ 10, sexual abuse score ≥ 8, emotional neglect
score ≥ 15, and physical neglect score ≥ 10 (Kim et al., 2013; Xie et al.,
2018). Cronbach's α of the CTQ-SF in this study was 0.86.
2.2.2. Stressful life events
Stressful life events were assessed using the Adolescent Self-Rating
Life Events Checklist (ASLEC; Liu et al., 1997) when participants were
in Grade 7. The scale includes 26 life events that may happen to Chinese
adolescents. Items that the adolescent had minimal or no control over
were categorized as independent life events (e.g., “A family member has
serious health problems”), and items were categorized as dependent life
events if the adolescent had some degree of control over the event (e.g.,
“Having arguments or fights with your classmates or friends”). The
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Journal of Affective Disorders 345 (2024) 85–93
categorization of independent versus dependent life events were based
on previous studies (Wade et al., 2019, 2022). Participants reported on
the presence/absence of each event during the past 12 months (absence
= 0). If any event had occurred, participants were required to rate each
item using a scale ranging from 1 (no impact) to 5 (extremely serious
impact). We produced scores for total, independent, and dependent SLEs
by summing the scores of all events belonging to the respective cate­
gories. In the present study, the Cronbach's α was 0.91.
2.2.3. Self-esteem
Adolescents' self-esteem in Grade 7 was measured with the 10-item
Rosenberg Self-esteem Scale (Rosenberg, 1965). As suggested by other
Chinese researchers, the eighth item was not suitable for measuring the
self-esteem for Chinese people (Tian et al., 2018), so the remaining 9
items was finally used in the current study. Participants reported on the
extent to which they endorsed each item on a 5-point Likert scale (1 =
strongly disagree, 5 = strongly agree). Four of the nine items were
reversed scored, and the average scores of all items were calculated,
with higher scores indicating a higher level of self-esteem. Cronbach's α
of this scale in the current study was 0.75.
2.2.4. Nonsuicidal self-injury
Nonsuicidal self-injury was assessed in Grade 7 and Grade 9 using a
shortened and modified version of the Deliberate Self-Harm Inventory
(DSHI; Gratz, 2001). A definition of NSSI was provided, and participants
reported their engagement in each given self-injury behavior in the past
six months. The DSHI includes 9 methods of NSSI (e.g., piercing,
burning), each rated on a 4-point scale (1 = never, 2 = once, 3 = 2–4
times, 4 = 5 or more times). We used the mean scores, with higher scores
indicating higher levels of NSSI. The Cronbach's α for the present study
was 0.84 in both Grade 7 and Grade 9.
2.3. Data analyses
First, preliminary analyses used independent-samples t-tests to test
for differences between groups (i.e., with and without a history of
maltreatment) in the levels of all variables of interest. Correlations
among study variables were calculated separately for the two groups.
Second, to examine the stress-sensitizing effect of child maltreatment on
NSSI, structural equation modeling was conducted to examine interac­
tive effects between SLEs (total, dependent, and independent) in Grade 7
and maltreatment history in predicting NSSI in Grade 9. The goodness-
of-fit of the models was estimated by the comparative fit index (CFI) and
the standardized root mean square residual (SRMR) and the root means
square error of approximation (RMSEA). Model fit was acceptable if CFI
≥ 0.90, SRMR ≤ 0.08, and RMSEA ≤ 0.08 (Wen et al., 2004). Within
each model, significant interactions were probed using simple slopes
tests (Aiken and West, 1991) and Johnson-Neyman method (Johnson
and Fay, 1950). For all analyses, age and sex were controlled as cova­
riates. Finally, multiple group analyses were conducted to examine
differences in the interactive effects of SLEs and self-esteem on NSSI
between the maltreated and non-maltreated groups. An unconstrained
model (i.e., all estimates were freely estimated) and a constrained model
(i.e., all estimates were invariant across groups) were compared to test
whether there were groups differences in paths.
3. Results
3.1. Preliminary analyses
Table 1 summarizes the descriptive statistics and bivariate correla­
tions among the study variables, with below the diagonal for adolescents
exposed to child maltreatment and above for adolescents without a
maltreatment history. As shown in Table 1, most variables were corre­
lated in the expected direction, but self-esteem was not significantly
associated with NSSI in Grade 9 in the non-maltreated group. Among
Y. Gao et al. Journal of Affective Disorders 345 (2024) 85–93

Table 1
Descriptive statistics and bivariate correlations between study variables.
Variables Maltreated (n Non- t Cohen's Bivariate correlations
= 207) maltreated (n d
= 339)

M SD M SD 1 2 3 4 5 6 7 8

1. Grade7 Stressful 2.38 0.69 2.03 0.65 5.38*** 0.52 – 0.95*** 0.85*** − 0.28*** 0.27*** 0.22*** − 0.09 − 0.003
life events
2. Grade7 Dependent 2.52 0.78 2.14 0.68 5.32*** 0.51 0.96*** – 0.65*** − 0.31*** 0.25*** 0.20** − 0.09 − 0.03
life events
3. Grade7 2.12 0.71 1.81 0.77 4.19*** 0.41 0.83*** 0.65*** – − 0.16** 0.23*** 0.21*** − 0.07 0.05
Independent life
events
4. Grade7 Self- 3.15 0.59 3.48 0.67 − 5.50*** 0.52 − 0.20** − 0.23** − 0.10 – − 0.16** − 0.08 0.15* − 0.01
esteem
5. Grade7 NSSI 1.23 0.41 1.11 0.24 3.61*** 0.37 0.37*** 0.32*** 0.38*** − 0.32*** – 0.41*** 0.02 − 0.12*
6. Grade9 NSSI 1.40 0.24 1.15 0.27 6.67*** 0.64 0.42*** 0.42*** 0.33*** − 0.31*** 0.48*** – − 0.03 − 0.13*
7. Sex – – – – – – − 0.01 − 0.04 0.05 0.10 0.03 − 0.15* – 0.07
8. Age 13.82 0.83 13.59 0.88 3.07** 0.27 0.01 − 0.01 0.05 0.05 − 0.06 0.01 0.07 –

Note: M = mean, SD = standard deviation; NSSI = Nonsuicidal self-injury. Sex was coded as 1 = male, 0 = female. Above the diagonal were the correlations among the
non-maltreated group and below the diagonal were among the maltreated group.
*
p < 0.05.
**
p < 0.01.
***
p < 0.001.

demographic variables, sex was found to be significantly associated with
NSSI in Grade 9 in the maltreated group, while age was negatively
associated with NSSI at both times in the non-maltreated group.
Therefore, sex and age were included in the further analyses.
3.2. Interactions between histories of child maltreatment and SLEs
First, separate models were conducted to examine the main and
interactive effects between child maltreatment (maltreated = 1, non-
maltreated = 0) and SLEs (total, independent, and dependent) with later
NSSI in the total sample. The model fit indices indicated that all models
were saturated (CFI = 1.000, SRMR = 0.000, RMSEA = 0.000). As
presented in Table 2, child maltreatment was directly associated with
NSSI in Grade 9 and interacted with total SLEs on NSSI in Grade 9.
Simple slope analyses revealed a significant association between total
SLEs and NSSI in the maltreated group (B = 0.05, SE = 0.01, p < 0.001)
but not in the non-maltreated group (B = 0.01, SE = 0.01, p = 0.094),
indicating a stress sensitizing effect.
When broken down into independent and dependent SLEs, there was
a significant interactive effect for dependent SLEs and child maltreat­
ment (Table 2, Model 3) but not independent SLEs and child maltreat­
ment (Table 2, Model 2). Simple slope analyses revealed the same
pattern as for total SLEs, with dependent SLEs significantly predicting
more NSSI in the maltreated group (B = 0.05, SE = 0.01, p < 0.001) than
in the non-maltreated group (B = 0.01, SE = 0.01, p = 0.148).
3.3. Moderating effects of self-esteem on relations between SLEs and NSSI
in maltreated and non-maltreated adolescents
Next, multiple group analyses were conducted to investigate group
differences in moderating effects of self-esteem on the relationship be­
tween SLEs (total, independent, and dependent) and NSSI. The uncon­
strained model (CFI = 1.000, SRMR = 0.038, RMSEA = 0.014) and
constrained model (CFI = 0.887, SRMR = 0.120, RMSEA = 0.090) of
total SLEs were significantly different (Δχ 2 (3) = 16.03, p < 0.01), so
were the models of dependent SLEs (Δχ 2 (3) = 7.97, p < 0.001) and
independent SLEs (Δχ 2 (3) = 9.27, p < 0.05), suggesting significant
differences between the two models across the maltreated and non-
maltreated groups. Thus, the relationships between SLEs, self-esteem,
and NSSI in the maltreated adolescents were different from that in the
non-maltreated adolescents.
As shown in Table 3, significant main effects of total and dependent
SLEs on NSSI in Grade 9 were also found in maltreated adolescents.
Moreover, significant interactions between self-esteem and SLEs in
predicting NSSI were observed in total (Table 3, Model 4) and dependent
SLEs (Table 3, Model 6), but not in independent SLEs (Table 3, Model 5).
Similar to the analyses in the maltreated sample, there were significant
main effects of SLEs as well as interactions between SLEs and self-esteem
in predicting NSSI in the non-maltreated sample for total (Table 3,
Model 4) and dependent SLEs (Table 3, Model 6), but not for indepen­
dent SLEs (Table 3, Model 5).
In maltreated adolescents, simple slope analyses (see Fig. 1a)
revealed that the associations between SLEs and NSSI were significant

Table 2
Regression tables of main and interactive effects of child maltreatment and SLEs on NSSI in Grade 9 in the total sample.
Model 1: total SLEs Model 2: independent SLEs Model 3: dependent SLEs

B SE β B SE β B SE β

Sex − 0.02 0.01 − 0.08 − 0.02 0.01 − 0.08 − 0.02 0.01 − 0.07
Age 0.001 0.01 0.004 0.000 0.01 0.001 0.001 0.01 0.01
Grade 7 NSSI 0.42*** 0.05 0.35 0.45*** 0.05 0.37 0.43*** 0.05 0.36
Child maltreatment 0.06*** 0.01 0.19 0.07*** 0.01 0.22 0.06*** 0.01 0.20
SLEs 0.01 0.01 0.09 0.01 0.01 0.08 0.01 0.01 0.08
Child maltreatment × SLEs 0.04** 0.01 0.16 0.02 0.01 0.09 0.04** 0.01 0.17

Note: SLEs = stressful life events; NSSI = Nonsuicidal self-injury. Sex was coded as 1 = male, 0 = female. Child maltreatment was coded as 1 = maltreated, 0 = non-
maltreated.
**
p < 0.01.
***
p < 0.001.

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Y. Gao et al. Journal of Affective Disorders 345 (2024) 85–93

Table 3
Regression tables of effects of sles and self-esteem on NSSI in the maltreated and non-maltreated sample separately.
Model 4: total SLEs Model 5: independent SLEs Model 6: dependent SLEs

B SE β B SE β B SE β

Maltreated
Sex − 0.05* 0.02 − 0.13 − 0.05 0.02 − 0.13 − 0.05 0.02 − 0.13
Age 0.02 0.01 0.11 0.02 0.01 0.11 0.02 0.01 0.11
Grade 7 NSSI 0.35*** 0.09 0.29 0.45*** 0.05 0.37 0.36*** 0.09 0.30
SLEs 0.04** 0.01 0.20 0.03 0.01 0.12 0.03* 0.01 0.19
Self-esteem − 0.02 0.02 − 0.09 − 0.03 0.01 − 0.12 − 0.01 0.01 − 0.07
Self-esteem × SLEs − 0.02* 0.01 − 0.18 − 0.02 0.01 − 0.11 − 0.03* 0.01 − 0.20

Non-maltreated
Sex − 0.003 0.01 − 0.01 − 0.004 0.01 − 0.02 − 0.003 0.01 − 0.01
Age − 0.01 0.01 − 0.09 − 0.01 0.01 − 0.10 − 0.01 0.01 − 0.08
Grade 7 NSSI 0.39*** 0.06 0.36 0.37*** 0.05 0.34 0.40*** 0.06 0.36
SLEs 0.02* 0.01 0.13 0.01* 0.01 0.13 0.02* 0.01 0.12
Self-esteem 0.003 0.01 0.03 0.00 0.01 0.00 0.004 0.01 0.04
Self-esteem × SLEs 0.01* 0.01 0.12 0.01 0.01 0.08 0.01* 0.01 0.12

Note: SLEs = stressful life events; NSSI = nonsuicidal self-injury. Sex was coded as 1 = male, 0 = female.
*
p < 0.05.
**
p < 0.01.
***
p < 0.001.

for those with low levels of self-esteem (–1SD) (total: B = 0.06, SE =

0.01, p < 0.001; dependent: B = 0.06, SE = 0.01, p < 0.001), but not for
adolescents with high levels of self-esteem (+1SD) (total: B = 0.01, SE =
0.02, p = 0.516; dependent: B = 0.01, SE = 0.02, p = 0.724). The
Johnson-Neyman technique for identifying significant regions (see
Fig. 2) further indicated that the impact of total and dependent SLEs on
NSSI among maltreated adolescents became significant when self-
esteem was lower than 0.27 SDs and 0.20 SDs above the mean, respec­
tively, and intensified as self-esteem decreased.
In non-maltreated adolescents, simple slope analyses (see Fig. 1b)
suggested that for those with high self-esteem (+1SD), SLEs was
significantly associated with more NSSI (total: B = 0.03, SE = 0.01, p <
0.01; dependent: B = 0.03, SE = 0.01, p < 0.01). For adolescents with
low self-esteem (–1SD), the association between SLEs and NSSI was not
significant (total: B = 0.002, SE = 0.01, p = 0.816; dependent: B =
0.001, SE = 0.01, p = 0.950). The Johnson-Neyman technique for
identifying significant regions (see Fig. 3) further indicated that the
impact of total and dependent SLEs on NSSI of non-maltreated adoles­
cents became significant when adolescents were higher than 0.19 SDs
and 0.06 SDs below the mean of self-esteem, respectively.

4. Discussion

The first goal of this study was to test whether child maltreatment
sensitize adolescents to the effects of current stressful life events on
NSSI, including whether these effects are conditional based on the type
of SLEs. The primary analyses indicated that more SLEs in Grade 7 were
associated with increased NSSI in Grade 9 among adolescents who
experienced child maltreatment, but not those who are not exposed to
maltreatment, supporting the stress sensitization hypothesis. Further
analyses showed that the stress-sensitizing effect only existed in
dependent (controllable) SLEs. We also tested whether the role of self-
esteem in buffering negative effects of SLEs on adolescent NSSI
differed by histories of maltreatment. The results showed that self-
esteem had different moderating effects on the relationships between
SLEs and NSSI among adolescents with or without child maltreatment
Fig. 1. Simple slopes for the interaction between dependent stressful life events
histories. For adolescents exposed to child maltreatment, those with
(SLEs) and self-esteem in predicting nonsuicidal self-injury (NSSI) for (a) the
lower self-esteem are more likely to be affected by SLEs, especially
maltreated group and (b) the non-maltreated group. The same pattern held for
total SLEs.
dependent SLEs, compared to those with higher self-esteem. However, in
non-maltreated adolescents, those with higher self-esteem were at
increased risk of engaging in NSSI following dependent, but not inde­
pendent, SLEs. This is among the first studies to demonstrate that child
maltreatment increases adolescents' sensitivity to dependent stress in

89
Y. Gao et al.
Fig. 2. Johnson-Neyman plot of the regions of significance of the interaction between dependent SLEs and self-esteem in predicting NSSI among the maltreated
adolescents. The same pattern held for total SLEs.
current life, and highlights the importance of self-esteem in moderating
the longitudinal relationships between SLEs and NSSI of adolescents
with different maltreatment experiences.
Previous studies of stress sensitization have focused on internalizing
and externalizing problems as outcomes (Espejo et al., 2007; Wade et al.,
2019; Weissman et al., 2020), with limited research examining the stress
sensitization hypothesis concerning NSSI in adolescence. This study
extends previous findings by showing that SLEs were only associated
with NSSI in maltreated adolescents, suggesting that childhood adver­
sities sensitized adolescents to later SLEs proximal to NSSI. Although the
mechanisms underlying stress sensitization reported in this study are not
clear, these mechanisms might operate through various emotional and
neurobiological pathways. For instance, it has been shown that child­
hood adversity was associated with reduced amygdala and hippocampal
volume and altered frontostriatal function (McLaughlin et al., 2019),
which may contribute to disrupted physiological responses to stress and
emotion processing (Weissman et al., 2020). Consequently, individuals
exposed to child maltreatment may display heightened physiological
and emotional reactivity to later stressors and have difficulties in
regulating negative emotions (Myers et al., 2014), thereby predisposing
youths to NSSI following SLEs. Furthermore, early adversity may predict
alterations in coping with stress through dysfunctional biological sys­
tems, according to the double hit model (Koss and Gunnar, 2018).
Exposure to early stress has been demonstrated to confer a risk of dys­
regulated hypothalamic-pituitary-adrenal (HPA) axis functioning,
which in turn affects individuals' behavioral responses in later stressful
situations (Young et al., 2019).
In addition to the stress-sensitizing effect detected for NSSI, the
current study provides novel evidence for the relationships between
different types of SLEs with NSSI. Consistent with prior evidence
demonstrating relationships between dependent SLEs and internalizing
problems in youths (Fassett-Carman et al., 2019), the present study
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Journal of Affective Disorders 345 (2024) 85–93
provided support for this relationship in NSSI as the stress-sensitizing
effect of child maltreatment on NSSI was only observed in dependent
SLEs. Prior research has indicated that childhood adversity is related
with altered structure and functions in amygdala, medial prefrontal
cortex (mPFC), hippocampal, and frontoparietal regions, which are
involved in social cognition, such as threat detection and emotion
regulation (Fassett-Carman et al., 2022; McLaughlin et al., 2019). Since
a large part of dependent stressful events involve interpersonal and so­
cial content, it is possible that individuals with a history of early
maltreatment are particularly sensitive to dependent stress during
adolescence. Another plausible possibility is that those who experience
maltreatment may develop cognitive vulnerabilities, such as self-
criticism, shame, and negative automatic thoughts (Glassman et al.,
2007; Hou et al., 2021; Mahtani et al., 2019). These cognitive vulnera­
bilities are more likely to lead to NSSI when individuals realize their
contribution to the cause of dependent stressors (Guerry and Prinstein,
2010; Lear et al., 2019), consistent with existing evidence that appraisals
of dependent stressors, but not independent stressors, are associated
with internalizing problems (Fassett-Carman et al., 2019). However, the
potential mechanisms through which child maltreatment sensitizes ad­
olescents to dependent stressors proximal to NSSI need further
exploration.
Furthermore, the present results highlight the moderating effect of
self-esteem on the relationship between SLEs and NSSI, as SLEs was only
associated with NSSI in maltreated adolescents with low self-esteem.
This was in line with the self-esteem buffering hypothesis (Orth et al.,
2009), indicating that high self-esteem is protective against later
stressful life events for maltreated adolescents. The results also provided
support for previous theoretical and empirical evidence suggesting that
negative self-views are a risk factor for NSSI (Hooley and Franklin, 2018;
Meng et al., 2022). Importantly, the buffering effect of self-esteem was
only found in dependent SLEs. Based on the sociometer theory of self-
Y. Gao et al.
Fig. 3. Johnson-Neyman plot of the regions of significance of the interaction between dependent SLEs and self-esteem in predicting NSSI among the non-maltreated
adolescents. The same pattern held for total SLEs.
esteem (Leary and Baumeister, 2000), it would be likely that self-esteem
can only buffer against maladaptive behaviors following dependent
stressors that may convey threatening information about the self. Our
findings suggest that, for those who are exposed to child maltreatment,
focusing on improving positive self-view (self-esteem) may be an
effective mean of intervention to NSSI, especially when they encounter
dependent SLEs.
However, contrary to our expectation and to most previous research,
the present study found that SLEs exerted a stronger effect on NSSI for
non-maltreated adolescents with high self-esteem than for those with
low self-esteem. Whereas many studies have investigated life stress, self-
esteem, and their relationship with psychopathology (Choi and Park,
2018; Ng et al., 2022; Orth et al., 2009), little is known about whether
these relationships varied according to individuals' experiences of
childhood adversity. The results of this study suggest that child
maltreatment may not only affect the associations between stress and
NSSI but also have implications for the role of self-esteem in these as­
sociations. Our findings among non-maltreated adolescents provided
support for the Self-Esteem as Stake Model (vanDellen et al., 2011),
which assumes that people with high self-esteem are relatively more
affected by threat because they have higher standards for positive self-
views and that threat would cause greater discrepancies between their
desired and current self-worth. From this perspective, when adolescents
with high self-esteem realize that negative events are occurring partly
because of them, dependent SLEs may threaten their self-esteem, thus
leading to more negative reactions. In fact, recent studies have found
that for youths with higher self-esteem, their affects and beliefs received
stronger impact from life stress (Bai et al., 2021; Xu et al., 2018), which
is consistent with the current findings.
It is possible that the heterogeneity of high self-esteem could explain
these results. Researchers have proposed that high self-esteem can be
defensive or secure, and that individuals with defensive high self-esteem
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Journal of Affective Disorders 345 (2024) 85–93
actually have an implicit negative self-view and are vulnerable to
external stress (Jordan et al., 2003). Although adolescents in the non-
maltreated group in this study have relatively higher levels of self-
esteem than those exposed to child maltreatment, some of these high­
ly self-esteem adolescents might have insecure self-view. They may
interpret SLEs, particularly dependent SLEs, as more ego-relevant,
thereby having more maladaptive reactions to stressors (Alessandri
et al., 2017; Zeigler-Hill et al., 2011). Nevertheless, our results should be
interpreted taking into account non-maltreated adolescents reporting
higher levels of self-esteem and lower levels of NSSI compared to the
adolescents exposed to maltreatment in the current study, which sug­
gested direct negative associations between self-esteem and NSSI.
Additionally, even if SLEs significantly predicted later NSSI among non-
maltreated adolescents with higher self-esteem in this study, the in­
crease in NSSI was limited. While investigating the mechanisms of these
results is beyond the scope of the current study, this work suggests that
self-esteem may have a more nuanced effect on the association between
stress and adolescent NSSI.
Our findings should, however, be interpreted with consideration of
several limitations. First, we did not collect information on the timing of
exposure to child maltreatment, which may have an impact on later
psychopathology. We encourage future research to assess child
maltreatment during critical periods of development (e.g., early child­
hood, Shonkoff, 2010). Second, the sample of this study only include
Grade 7 students at baseline, which may limit the extent to which our
results can be extrapolated to broader populations (e.g., adolescents in
senior high schools). Additionally, it is also possible that adolescents
who have experienced child maltreatment may be less likely to partic­
ipate in our study, potentially due to parental reluctance to provide
consent or other factors stemming from their experiences. This could
potentially lead to an underestimation of certain effects in our analyses.
Future studies should consider employing more comprehensive and
Y. Gao et al.
diverse sampling strategies to mitigate the potential for selection bias
and enhance the representativeness of samples. Third, researchers have
suggested that there are multiple forms of high self-esteem (Jordan
et al., 2003). While the current study only assessed the general positive
self-view, or the explicit self-esteem, it may be interesting to explore the
role of heterogeneous high self-esteem in moderating the associations
among child maltreatment, SLEs, and NSSI. Fourth, the data of child
maltreatment and stressful life events were self-report measures, which
could be susceptible to reporting biases and might increase the associ­
ations among the variables of interest due to a common method variance
problem. Future studies could benefit from gathering information from
different resources such as parents. Finally, there is a possibility that
mental health problems could indeed lead to dependent SLEs but not
independent SLEs. Thus, future research that investigate the dynamic
interplay between SLEs and psychopathology over time will help to
provide further insight into the temporal sequence of events.
Despite these limitations, the present study highlights the impor­
tance of considering the experiences of early adversity when investi­
gating the interactive effects of recent life stress and individual resources
on adolescent NSSI. The current findings add NSSI to the existing liter­
ature about stress sensitizing effects of early adversity on psychopa­
thology. As one of the first studies to differentiate dependent and
independent life events when examining the risk factors for NSSI, this
study also emphasizes the important role of the types of SLEs in affecting
adolescent NSSI. Together, these findings indicate that interventions
targeting self-esteem may be more effective for maltreated adolescents
to better cope with dependent SLEs and reduce NSSI.
Ethics approval
Approval was obtained from the ethics committee of Institutional
Review Board of the Faculty of Psychology, Beijing Normal University.
The procedures used in this study adhere to the tenets of the Declaration
of Helsinki.
Consent to participate
Participants provided active informed consent and their primary
caregivers gave written informed consent for the assessment.
Funding
This work was supported by National Natural Science Foundation of
China (General Program: 32171069).
CRediT authorship contribution statement
Y.G. participated in its design and coordination, and drafted the
manuscript; C.L. helped in drafting and editing the manuscript; X.L.
conceived of the study, participated in its design and coordination, and
helped in drafting the manuscript; R.B. participated in the interpretation
of the data and helped drafting the manuscript; S.X. contributed to
acquisition of the data. All authors read and approved the final
manuscript.
Declaration of competing interest
We declare that we have no conflict of interest.
Data availability
The datasets generated during and/or analyzed during the current
study are available from the corresponding author on reasonable
request. Please contact liuxia@bnu.edu.cn.
92
Journal of Affective Disorders 345 (2024) 85–93
Acknowledgments
We are grateful to the students and their parents, the principal and
teachers who contributed to this study.
References
Aiken, L.S., West, S.G., 1991. Multiple Regression: Testing and Interpreting Interactions.
Sage Publications, Inc.
Alessandri, G., Perinelli, E., De Longis, E., Rosa, V., Theodorou, A., Borgogni, L., 2017.
The costly burden of an inauthentic self: insecure self-esteem predisposes to
emotional exhaustion by increasing reactivity to negative events. Anxiety Stress
Coping 30 (6), 630–646. https://doi.org/10.1080/10615806.2016.1262357.
Andersen, S.L., Teicher, M.H., 2008. Stress, sensitive periods and maturational events in
adolescent depression. Trends Neurosci. 31 (4), 183–191. https://doi.org/10.1016/j.
tins.2008.01.004.
Babcock Fenerci, R.L., Jenkins, G.A., Gilbert, A.C., Schettini, E., Musella, K.,
MacPherson, H., Kim, K.L., Kudinova, A.Y., Radoeva, P.D., Dickstein, D.P., 2022.
Maltreatment history and reasons for self-injurious behavior among adolescents
engaged in non-suicidal self-injury versus adolescents who attempted suicide.
Suicide Life Threat. Behav. 52 (5), 898–907. https://doi.org/10.1111/sltb.12887.
Bai, Q., Huang, S., Hsueh, F.-H., Zhang, T., 2021. Cyberbullying victimization and
suicide ideation: a crumbled belief in a just world. Comput. Hum. Behav. 120,
106679 https://doi.org/10.1016/j.chb.2021.106679.
Bernstein, D.P., Stein, J.A., Newcomb, M.D., Walker, E., Pogge, D., Ahluvalia, T.,
Stokes, J., Handelsman, L., Medrano, M., Desmond, D., Zule, W., 2003. Development
and validation of a brief screening version of the Childhood Trauma Questionnaire.
Child Abuse Negl. 27 (2), 169–190. https://doi.org/10.1016/S0145-2134(02)
00541-0.
Choi, B., Park, S., 2018. Who becomes a bullying perpetrator after the experience of
bullying victimization? The moderating role of self-esteem. J. Youth Adolesc. 47
(11), 2414–2423. https://doi.org/10.1007/s10964-018-0913-7.
Del Giudice, M., Ellis, B.J., Shirtcliff, E.A., 2011. The adaptive calibration model of stress
responsivity. Neurosci. Biobehav. Rev. 35 (7), 1562–1592. https://doi.org/10.1016/
j.neubiorev.2010.11.007.
Espejo, E.P., Hammen, C.L., Connolly, N.P., Brennan, P.A., Najman, J.M., Bor, W., 2007.
Stress sensitization and adolescent depressive severity as a function of childhood
adversity: a link to anxiety disorders. J. Abnorm. Child Psychol. 35 (2), 287–299.
https://doi.org/10.1007/s10802-006-9090-3.
Fassett-Carman, A., Hankin, B.L., Snyder, H.R., 2019. Appraisals of dependent stressor
controllability and severity are associated with depression and anxiety symptoms in
youth. Anxiety Stress Coping 32 (1), 32–49. https://doi.org/10.1080/
10615806.2018.1532504.
Fassett-Carman, A.N., Smolker, H., Hankin, B.L., Snyder, H.R., Banich, M.T., 2022.
Neuroanatomical correlates of perceived stress controllability in adolescents and
emerging adults. Cogn. Affect. Behav. Neurosci. 22 (4), 655–671. https://doi.org/
10.3758/s13415-022-00985-2.
Glassman, L.H., Weierich, M.R., Hooley, J.M., Deliberto, T.L., Nock, M.K., 2007. Child
maltreatment, non-suicidal self-injury, and the mediating role of self-criticism.
Behav. Res. Ther. 45 (10), 2483–2490. https://doi.org/10.1016/j.brat.2007.04.002.
Gratz, K.L., 2001. Measurement of deliberate self-harm: preliminary aata on the
deliberate self-harm inventory. J. Psychopathol. Behav. Assess. 23 (4), 253–263.
https://doi.org/10.1023/A:1012779403943.
Guerry, J.D., Prinstein, M.J., 2010. Longitudinal prediction of adolescent nonsuicidal
self-injury: examination of a cognitive vulnerability-stress model. J. Clin. Child
Adolesc. Psychol. 39 (1), 77–89. https://doi.org/10.1080/15374410903401195.
Hamilton, J.L., Stange, J.P., Abramson, L.Y., Alloy, L.B., 2015. Stress and the
development of cognitive vulnerabilities to depression explain sex differences in
depressive symptoms during adolescence. Clin. Psychol. Sci. 3 (5), 702–714. https://
doi.org/10.1177/2167702614545479.
Ho, T.T.Q., Gu, C., Wang, L., 2022. Coping strategies and depression among
cyberbullying victims in Vietnam: self-esteem as a moderator. Technol. Soc. 68,
101827 https://doi.org/10.1016/j.techsoc.2021.101827.
Hooley, J.M., Franklin, J.C., 2018. Why do people hurt themselves? A new conceptual
model of nonsuicidal self-injury. Clin. Psychol. Sci. 6 (3), 428–451. https://doi.org/
10.1177/2167702617745641.
Hooley, J.M., Ho, D.T., Slater, J., Lockshin, A., 2010. Pain perception and nonsuicidal
self-injury: a laboratory investigation. Personal. Disord. Theory Res. Treat. 1 (3),
170–179. https://doi.org/10.1037/a0020106.
Hou, X.-L., Bian, X.-H., Zuo, Z.-H., Xi, J.-Z., Ma, W.-J., Owens, L.D., 2021. Childhood
maltreatment on young adult depression: a moderated mediation model of negative
automatic thoughts and self-compassion. J. Health Psychol. 26 (13), 2552–2562.
https://doi.org/10.1177/1359105320918351.
Jhang, F.-H., 2020. Uncontrollable and controllable negative life events and changes in
mental health problems: exploring the moderation effects of family support and self-
efficacy in economically disadvantaged adolescents. Child Youth Serv. Rev. 118,
105417 https://doi.org/10.1016/j.childyouth.2020.105417.
Johnson, P.O., Fay, L.C., 1950. The Johnson-Neyman technique, its theory and
application. Psychometrika 15 (4), 349–367. https://doi.org/10.1007/BF02288864.
Jordan, C.H., Spencer, S.J., Zanna, M.P., Hoshino-Browne, E., Correll, J., 2003. Secure
and defensive high self-esteem. J. Pers. Soc. Psychol. 85, 969–978. https://doi.org/
10.1037/0022-3514.85.5.969.
Kim, D., Bae, H., Han, C., Oh, H.Y., MacDonald, K., 2013. Psychometric properties of the
Childhood Trauma Questionnaire-Short Form (CTQ-SF) in Korean patients with
Y. Gao et al.
schizophrenia. Schizophr. Res. 144 (1), 93–98. https://doi.org/10.1016/j.
schres.2012.12.020.
Koss, K.J., Gunnar, M.R., 2018. Annual research review: early adversity, the
hypothalamic–pituitary–adrenocortical axis, and child psychopathology. J. Child
Psychol. Psychiatry 59 (4), 327–346. https://doi.org/10.1111/jcpp.12784.
La Rocque, C.L., Harkness, K.L., Bagby, R.M., 2014. The differential relation of childhood
maltreatment to stress sensitization in adolescent and young adult depression.
J. Adolesc. 37 (6), 871–882. https://doi.org/10.1016/j.adolescence.2014.05.012.
Lear, M.K., Wilkowski, B.M., Pepper, C.M., 2019. A daily diary investigation of the
defective self model among college students with recent self-injury. Behav. Ther. 50
(5), 1002–1012. https://doi.org/10.1016/j.beth.2019.03.005.
Leary, M.R., Baumeister, R.F., 2000. The nature and function of self-esteem: sociometer
theory. In: Advances in Experimental Social Psychology, vol. 32. Academic Press,
pp. 1–62. https://doi.org/10.1016/S0065-2601(00)80003-9.
Lim, K.S., Wong, C.H., McIntyre, R.S., Wang, J., Zhang, Z., Tran, B.X., Tan, W., Ho, C.S.,
Ho, R.C., 2019. Global lifetime and 12-month prevalence of suicidal behavior,
deliberate self-harm and non-suicidal self-injury in children and adolescents between
1989 and 2018: a meta-analysis. Int. J. Environ. Res. Public Health 16 (22). https://
doi.org/10.3390/ijerph16224581.
Liu, X., Liu, L.Q., Yang, J., Zhao, G.F., 1997. Reliability and validity of the adolescents
self-rating life events checklist. Chin. J. Clin. Psychol. 5 (1), 34–36 (Scopus).
Liu, R.T., Frazier, E.A., Cataldo, A.M., Simon, V.A., Spirito, A., Prinstein, M.J., 2014.
Negative life events and non-suicidal self-injury in an adolescent inpatient sample.
Arch. Suicide Res. 18 (3), 251–258. https://doi.org/10.1080/
13811118.2013.824835.
MacKin, D.M., Perlman, G., Davila, J., Kotov, R., Klein, D.N., 2017. Social support buffers
the effect of interpersonal life stress on suicidal ideation and self-injury during
adolescence. Psychol. Med. 47 (6), 1149–1161. https://doi.org/10.1017/
S0033291716003275.
Mahtani, S., Hasking, P., Melvin, G.A., 2019. Shame and non-suicidal self-injury:
conceptualization and preliminary test of a novel developmental model among
emerging adults. J. Youth Adolesc. 48 (4), 753–770. https://doi.org/10.1007/
s10964-018-0944-0.
McLaughlin, K.A., Koenen, K.C., Bromet, E.J., Karam, E.G., Liu, H., Petukhova, M.,
Ruscio, A.M., Sampson, N.A., Stein, D.J., Aguilar-Gaxiola, S., Alonso, J., Borges, G.,
Demyttenaere, K., Dinolova, R.V., Ferry, F., Florescu, S., de Girolamo, G., Gureje, O.,
Kawakami, N., Kessler, R.C., 2017. Childhood adversities and post-traumatic stress
disorder: evidence for stress sensitisation in the World Mental Health Surveys. Br. J.
Psychiatry 211 (5), 280–288. https://doi.org/10.1192/bjp.bp.116.197640.
McLaughlin, K.A., Weissman, D., Bitrán, D., 2019. Childhood adversity and neural
development: a systematic review. Annu. Rev. Dev. Psychol. 1 https://doi.org/
10.1146/annurev-devpsych-121318-084950.
Meng, L., Qu, D., Bu, H., Huo, L., Qi, L., Yang, J., Zheng, T., Du, X., He, K., Wang, Y.,
Zhou, Y., 2022. The psychosocial correlates of non-suicidal self-injury within a
sample of adolescents with mood disorder. Front. Public Health 10. https://www.
frontiersin.org/articles/10.3389/fpubh.2022.768400.
Mo, J., Wang, C., Niu, X., Jia, X., Liu, T., Lin, L., 2019. The relationship between
impulsivity and self-injury in Chinese undergraduates: the chain mediating role of
stressful life events and negative affect. J. Affect. Disord. 256 (393), 259–266.
https://doi.org/10.1016/j.jad.2019.05.074.
Moya-Higueras, J., Cuevas, A., Marques-Feixa, L., Mezquita, L., Mayoral, M., Fañanás, L.,
Ortet, G., Ibáñez, M.I., 2020. Recent stressful life events (SLE) and adolescent mental
health: initial validation of the LEIA, a new checklist for SLE assessment according to
their severity, interpersonal, and dependent nature. Assessment 27 (8), 1777–1795.
https://doi.org/10.1177/1073191118817648.
Myers, B., McLaughlin, K.A., Wang, S., Blanco, C., Stein, D.J., 2014. Associations
between childhood adversity, adult stressful life events, and past-year drug use
disorders in the National Epidemiological Study of Alcohol and Related Conditions
(NESARC). Psychol. Addict. Behav. 28, 1117–1126. https://doi.org/10.1037/
a0037459.
Ng, M.H.S., Lua, V.Y.Q., Majeed, N.M., Hartanto, A., 2022. Does trait self-esteem serve as
a protective factor in maintaining daily affective well-being? Multilevel analyses of
daily diary studies in the US and Singapore. Personal. Individ. Differ. 198, 111804
https://doi.org/10.1016/j.paid.2022.111804.
Nock, M.K., 2009. Why do people hurt themselves? New insights into the nature and
functions of self-injury. Curr. Dir. Psychol. Sci. 18 (2), 78–83.
93
Journal of Affective Disorders 345 (2024) 85–93
Orth, U., Robins, R.W., Meier, L.L., 2009. Disentangling the effects of low self-esteem and
stressful events on depression: findings from three longitudinal studies. J. Pers. Soc.
Psychol. 97, 307–321. https://doi.org/10.1037/a0015645.
Pulopulos, M.M., Hoorelbeke, K., Vandenbroucke, S., Van Durme, K., Hooley, J.M., De
Raedt, R., 2022. The interplay between self-esteem, expectancy, cognitive control,
rumination, and the experience of stress: a network analysis. Curr. Psychol. https://
doi.org/10.1007/s12144-022-02840-6.
Ribeiro, J.D., Franklin, J.C., Fox, K.R., Bentley, K.H., Kleiman, E.M., Chang, B.P.,
Nock, M.K., 2016. Self-injurious thoughts and behaviors as risk factors for future
suicide ideation, attempts, and death: a meta-analysis of longitudinal studies.
Psychol. Med. 46 (2) https://doi.org/10.1017/S0033291715001804.
Rosenberg, M., 1965. Society and the Adolescent Self-image. Princeton University Press.
Shapero, B.G., Black, S.K., Liu, R.T., Klugman, J., Bender, R.E., Abramson, L.Y., Alloy, L.
B., 2014. Stressful life events and depression symptoms: the effect of childhood
emotional abuse on stress reactivity. J. Clin. Psychol. 70 (3), 209–223. https://doi.
org/10.1002/jclp.22011.
Shonkoff, J.P., 2010. Building a new biodevelopmental framework to guide the future of
early childhood policy. Child Dev. 81 (1), 357–367. https://doi.org/10.1111/j.1467-
8624.2009.01399.x.
Tang, J., Li, G., Chen, B., Huang, Z., Zhang, Y., Chang, H., Wu, C., Ma, X., Wang, J.,
Yu, Y., 2018. Prevalence of and risk factors for non-suicidal self-injury in rural China:
results from a nationwide survey in China. J. Affect. Disord. 226 (September 2017),
188–195. https://doi.org/10.1016/j.jad.2017.09.051.
Tian, L., Yuan, J., Li, Y., 2018. Effects of peer presence and self-esteem on adolescent
risk-taking behavior: evidence from an ERP study. Acta Psychol. Sin. 50 (1), 47.
https://doi.org/10.3724/SP.J.1041.2018.00047.
vanDellen, M.R., Campbell, W.K., Hoyle, R.H., Bradfield, E.K., 2011. Compensating,
resisting, and breaking: a meta-analytic examination of reactions to self-esteem
threat. Personal. Soc. Psychol. Rev. 15 (1), 51–74. https://doi.org/10.1177/
1088868310372950.
Wade, M., Zeanah, C.H., Fox, N.A., Tibu, F., Ciolan, L.E., Nelson, C.A., 2019. Stress
sensitization among severely neglected children and protection by social
enrichment. Nat. Commun. 10 (1), 1 https://doi.org/10.1038/s41467-019-13622-3.
Wade, M., McLaughlin, K.A., Buzzell, G.A., Fox, N.A., Zeanah, C.H., Nelson, C.A., 2022.
Family-based care buffers the stress sensitizing effect of early deprivation on
executive functioning difficulties in adolescence. Child Dev. n/a (n/a) https://doi.
org/10.1111/cdev.13863.
Weissman, D.G., Lambert, H.K., Rodman, A.M., Peverill, M., Sheridan, M.A.,
McLaughlin, K.A., 2020. Reduced hippocampal and amygdala volume as a
mechanism underlying stress sensitization to depression following childhood
trauma. Depress. Anxiety 37 (9). https://doi.org/10.1002/da.23062.
Wen, Z., Hau, K.-T., Marsh, H.W., 2004. Structural equation model testing: cutoff criteria
for goodness of fit indices and chi-square test. Acta Psychol. Sin. 36 (2), 186–194.
Xie, P., Wu, K., Zheng, Y., Guo, Y., Yang, Y., He, J., Ding, Y., Peng, H., 2018. Prevalence
of childhood trauma and correlations between childhood trauma, suicidal ideation,
and social support in patients with depression, bipolar disorder, and schizophrenia in
southern China. J. Affect. Disord. 228 (September 2017), 41–48. https://doi.org/
10.1016/j.jad.2017.11.011.
Xu, L., Wu, P., He, W., 2018. Meta-stereotype threat effects on intergroup relations
among impoverished undergraduates: a moderated mediation model of intergroup
anxiety and self-esteem. Psychol. Dev. Educ. 34 (4), 426–433. https://doi.org/
10.16187/j.cnki.issn1001-4918.2018.04.06.
Young, E.S., Farrell, A.K., Carlson, E.A., Englund, M.M., Miller, G.E., Gunnar, M.R.,
Roisman, G.I., Simpson, J.A., 2019. The dual impact of early and concurrent life
stress on adults’ diurnal cortisol patterns: a prospective study. Psychol. Sci. 30 (5),
739–747. https://doi.org/10.1177/0956797619833664.
Yuan, Y., Wang, Z., Sun, Q., Wang, D., Yin, X., Li, Z., 2022. The relationship between
cumulative family risk and emotional problems among impoverished children: a
moderated mediation model. Psychol. Dev. Educ. 38 (1), 100–108. https://doi.org/
10.16187/j.cnki.issn1001-4918.2022.01.12.
Zeigler-Hill, V., Besser, A., King, K., 2011. Contingent self-esteem and anticipated
reactions to interpersonal rejection and achievement failure. J. Soc. Clin. Psychol. 30
(10), 1069–1096. https://doi.org/10.1521/jscp.2011.30.10.1069.
Zheng, Y., Yang, X., Liu, Q., Chu, X., Huang, Q., Zhou, Z., 2020. Perceived stress and
online compulsive buying among women: a moderated mediation model. Comput.
Hum. Behav. 103, 13–20. https://doi.org/10.1016/j.chb.2019.09.012.