Adverse childhood experience and non-suicidal self-injury in male prisoners: a chain mediating effect through sense of security and emotional problems

Abstract

Introduction: Non-suicidal self-injury (NSSI) is highly prevalent among prisoners and poses substantial challenges to prison management. This study examined the mechanisms linking adverse childhood experiences (ACEs) to NSSI among male prisoners, with a focus on the serial mediating roles of sense of security and emotional problems. Methods: A sample of 1,205 male inmates from two Chinese prisons completed self-report measures assessing ACEs, sense of security, emotional problems, and NSSI. Responses from 398 incarcerated individuals were included in the subsequent analysis due to their engagement in NSSI behaviors. Results: The use of structural equation modeling revealed a significant association between ACEs and NSSI among prisoners, with the model providing robust support for the hypothesized predictive pathway. Sense of security and emotional problems sequentially mediated the relationship between ACEs and NSSI. Specifically, ACEs were associated with a diminished sense of security, which was in turn linked to more severe emotional problems; collectively, these factors predicted an increased risk of NSSI. While ACEs exhibited both direct and indirect associations with NSSI behaviors, its relationship with NSSI functions was fully mediated by the pathway involving sense of security and emotional problems. Discussion: These findings highlight the importance of addressing early trauma, enhancing perceived security, and improving emotional regulation via correctional mental health interventions to reduce NSSI among incarcerated individuals.