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Adherence to 24-h movement guidelines, particularly including the sleep guideline, is associated with lower odds of non-suicidal self-injury in adolescents, with mediation by psychological health and moderation by sex.

In a cross-sectional study of 4,205 Chinese adolescents, meeting more 24-h movement guidelines was associated with progressively lower odds of NSSI (1 vs 0: OR=0.72; 2 vs 0: OR=0.44; 3 vs 0: OR=0.31). Combinations including the sleep guideline were associated with lower NSSI than those without, and the association was stronger in girls. Psychological health significantly mediated the relationship.

Last updated: Aug 8, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Associations between adherence to 24-h movement guidelines and non-suicidal self-injury in adolescents: separate moderation by sex and mediation by psychological health.

observational

Wang C, Fan Y, Ren X, Zou Y, Tan S, Yang Y, Yao Q, Qian H · Frontiers in public health (2026)

Participants: N/A
Duration: N/A (cross-sectional)
Intervention: Adherence to 24-h movement guidelines (moderate-to-vigorous physical activity, screen time, sleep duration) as assessed by self-report.
Outcome: Non-suicidal self-injury (NSSI) prevalence, psychological health (mediator), sex moderation.
Effect Size: OR=0.31 (95% CI 0.15-0.65) for meeting all three guidelines vs none; OR=0.72 (95% CI 0.34-1.49) for 3 vs 2 guidelines.
Population: Adolescents (N=4,205) from five central Chinese cities.

Result:

PubMed: 42553275DOI: 10.3389/fpubh.2026.1840941

Mechanism Graph

Adherence to movement guidelines (especially sleep) is associated with better psychological health.
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Better psychological health is associated with lower NSSI risk.
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Sex moderates the association, with stronger effects in girls.
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Result: Meeting more guidelines, particularly including sleep, is linked to reduced NSSI odds.

Limitations

  • ⚠Cross-sectional design precludes causal inference.
  • ⚠Self-reported measures may introduce recall bias.
  • ⚠Sample limited to urban Chinese adolescents, limiting generalizability.
  • ⚠Low adherence to all three guidelines (1.28%) may reduce statistical power for some comparisons.

Frequently Asked Questions

What is the prevalence of NSSI in this study?▼

The prevalence of NSSI was 35.29% among the 4,205 adolescents.

Which movement guideline was most strongly associated with lower NSSI?▼

Combinations including the sleep guideline were associated with lower NSSI than those without, suggesting sleep is particularly important.

Did meeting all three guidelines provide additional benefit over meeting two?▼

No significant additional reduction was found (OR=0.72, 95% CI 0.34-1.49), indicating that meeting two guidelines may be sufficient for some benefit.

Was the association different for boys and girls?▼

Yes, sex significantly moderated the association for meeting two guidelines and the 'screen + sleep' combination, with stronger negative associations in girls.

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References

  1. 1.Wang C, Fan Y, Ren X, Zou Y, Tan S, Yang Y, Yao Q, Qian H. "Associations between adherence to 24-h movement guidelines and non-suicidal self-injury in adolescents: separate moderation by sex and mediation by psychological health.." Frontiers in public health, 2026. PMID: 42553275 DOI: 10.3389/fpubh.2026.1840941
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.