Family functioning types and self-injury risk among left-behind secondary school students: a latent profile analysis with shame as a mediator

Front Psychol. 2026 May 18;17:1799872. doi: 10.3389/fpsyg.2026.1799872. eCollection 2026.

ABSTRACT

OBJECTIVE: To identify latent profiles of family functioning among left-behind secondary school students and to examine their associations with non-suicidal self-injury (NSSI), as well as the mediating role of shame.

METHODS: A cross-sectional survey using cluster sampling was conducted in 2024 among 2,385 secondary school students from two rural schools in Huaihua City, Hunan Province. Family functioning was assessed using the Family APGAR scale, shame was measured using the Shame Scale, and non-suicidal self-injury (NSSI) was evaluated based on DSM-5 criteria via a self-report questionnaire. Latent profile analysis (LPA) was used to classify family functioning. Multivariable logistic regression and linear regression models were applied to assess the associations among family functioning, shame, and NSSI. Causal mediation analysis was performed to evaluate the mediating effect of shame.

RESULTS: Three latent profiles of family functioning were identified: low, moderate, and high functioning. After adjusting for potential confounders: (1) compared with students in the high-functioning profile, those in the low-functioning (OR = 1.686, 95% CI: 1.346-2.114) and moderate-functioning profiles (OR = 2.880, 95% CI: 2.125-3.921) had a significantly higher risk of NSSI; (2) shame scores were significantly higher in the low-functioning (β = 2.987) and moderate-functioning profiles (β = 3.762) (both P < 0.001); and (3) each one-point increase in shame was associated with a 33% higher risk of NSSI (OR = 1.330, 95% CI: 1.260-2.041). Mediation analyses indicated that shame partially mediated the association between family functioning and NSSI (low vs. high functioning: mediated proportion = 17.20%; moderate vs. high functioning: mediated proportion = 10.32%).

CONCLUSION: Family functioning among left-behind secondary school students is heterogeneous. Lower levels of family functioning not only directly increase the risk of NSSI but also indirectly influence self-injurious behavior through elevated shame. Shame represents a key psychological mechanism. These findings suggest that interventions should focus on improving family functioning and reducing shame, such as enhancing family communication and providing school-based psychological support, to effectively prevent and reduce NSSI among this vulnerable population.

PMID:42233080 | PMC:PMC13222795 | DOI:10.3389/fpsyg.2026.1799872