Psychological flexibility typologies and non-suicidal self-injury behavior among Chinese adolescents: a latent profile and multiple mediation analysis.

BACKGROUND: Non-suicidal self-injury (NSSI) is a common concern among adolescents. While psychological flexibility (PF) has been established as a key protective factor that prevents NSSI in adolescents, its potential heterogeneity and the mechanisms by which PF influences NSSI remain unclear. The purpose of this study was to explore the heterogeneity of PF among Chinese adolescents and examine whether negative emotions and school interpersonal relationships mediate the associations between PF profiles and NSSI behavior. METHODS: A convenience sampling method was employed. Participants included 1,562 Chinese adolescents (mean age 13.13 years, SD = 0.99; 54.42% males) from Anhui Province. Latent profile analysis (LPA) was performed to identify the heterogeneity in adolescent PF, and structural equation modeling (SEM) was performed to examine the multiple mediating roles of negative emotions and school interpersonal relationships in the associations between PF profiles and NSSI behavior. RESULTS: The following five distinct PF profiles were identified: the weakly open-highly engaged subgroup (4.42%), the low-PF subgroup (15.43%), the medium-PF subgroup (33.80%), the high-PF subgroup (33.35%), and the extremely high-PF subgroup (13.00%). Both negative emotions and school interpersonal relationships significantly mediated the associations between PF profiles and NSSI behavior. Compared with adolescents in the extremely high PF subgroup, adolescents in the weakly open-highly engaged subgroup, low-PF subgroup, and medium-PF subgroup presented higher levels of negative emotions, poorer school interpersonal relationships, and greater degrees of NSSI behavior. In particular, among the five profile groups, adolescents in the weakly open-highly engaged subgroup exhibited the greatest degree of NSSI behavior. CONCLUSIONS: PF profile affected NSSI behavior among adolescents indirectly through negative emotions and school interpersonal relationships, and stronger multiple mediating effects were observed among adolescents with lower levels of PF and openness. Our study highlights the importance of focusing on the heterogeneity of PF among adolescents, the critical role of openness, and the need for tailored interventions to improve PF as well as emotional, interpersonal, and behavioral issues.