TY  - JOUR
AU  - Zhang, Yi
AU  - Ying, Ruixue
AU  - Lu, Wan
AU  - Liu, Xuemeng
AU  - Hu, Keyan
AU  - Feng, Qing
AU  - Yu, Zixiang
AU  - Wang, Zhen
AU  - Lu, Fangting
AU  - Miao, Yahu
AU  - Ma, Nanzhen
AU  - Tao, Fangbiao
AU  - Jiang, Tian
AU  - Zhang, Qiu
PY  - 2025
DA  - 2025/2/21
TI  - Association Among BMI, Self-Esteem, and Nonsuicidal Self-Injury in Young Adults to Understand the Influence of Socioenvironmental Factors: Longitudinal Study
JO  - JMIR Public Health Surveill
SP  - e52928
VL  - 11
KW  - nonsuicidal self-injury
KW  - chronotype
KW  - BMI
KW  - self-esteem
KW  - body mass index
KW  - adolescent
KW  - young adult
KW  - teenager
KW  - social environmental factor
KW  - self-injury
KW  - sampling method
KW  - undergraduate
KW  - college student
KW  - linear regression
KW  - regression
KW  - regression model
AB  - Background: Nonsuicidal self-injury (NSSI) is a major public health problem leading to psychological problems in adolescents and young adults, similar to disorders such as depression and anxiety. Objective: The aims of this study were to investigate (1) the interaction between BMI and socioenvironmental factors (including chronotype and mental health) that contribute to NSSI, and (2) whether self-esteem plays a mediating role in this association. Methods: From May to June 2022, the multistage cluster sampling method was used to sample college students in four grades, including freshmen and seniors. The baseline participants were followed up 6 months later, excluding those who did not qualify, and the participants included 1772 college students. Socioenvironmental factors (chronotype/mental health), self-esteem, and NSSI were measured using a questionnaire. Multivariate linear regression models and chi-square analysis were used to evaluate the linear relationship between BMI, socioenvironmental factors, and self-esteem and the NSSI status. We use a process approach (mediation-moderation analysis) to explore the complex relationships between these variables. Results: The mean age of the participants was 20.53 (SD 1.65) years at baseline. A significant association was revealed, suggesting that a high BMI (β=.056, 95% CI 0.008‐0.086, P=.018) was associated with a higher NSSI. There was also an interaction among BMI, socioenvironmental factors, and NSSI. Socioenvironmental factors played both moderating and mediating roles in the relationship between BMI and NSSI, whereas self-esteem only played a mediating role. Conclusions: Paying attention to factors such as overweight and obesity is important for early BMI control to identify other potential risk factors for NSSI and to evaluate how self-esteem can be improved considering multiple perspectives to improve the effect of BMI on NSSI in adolescents. 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2025/1/e52928
UR  - https://doi.org/10.2196/52928
DO  - 10.2196/52928
ID  - info:doi/10.2196/52928
ER  -