The reciprocal relationship between depressive symptoms and deliberate self-harm among Chinese rural adolescents: a cross-lagged panel analysis

While the association between depressive symptoms and deliberate self-harm in adolescence is extensively documented, the nature, bi-directionality, and longitudinal dynamics of this relationship remain underexplored. This study aims to investigate the causal and reciprocal relationship between depressive symptoms and deliberate self-harm among rural adolescents in western China. A 2-year panel study was conducted among 1,840 adolescents aged 10-18 attending rural junior and senior high schools in Sichuan Province, China. The Center for Epidemiologic Studies-Depression Scale (CES-D) and a global measure of self-reported deliberate self-harm were utilized to examine the relationship between depressive symptoms and deliberate self-harm using both classic and random intercept cross-lagged panel models. Multi-group comparisons were carried out for the gender, pubertal stage, and academic performance subgroups. Positive and statistically significant correlations were found between depressive symptoms and deliberate self-harm both within and across the three waves of the panel survey, after adjusting for covariates, among rural adolescents in western China ( : 0.05-0.28,