Adolescent Self-Harm: Associations with Depressive Symptoms, Age, and Sex in Cross-Sectional Samples from 2019 and 2025

Abstract

Self-harm during adolescence represents a significant behavioral and public health concern associated with increased psychological vulnerability. The present study aimed to examine the relationship between depressive symptoms and self-harm in adolescents across two time points (2019 and 2025), with a particular focus on age and sex differences. Data were obtained from two national cross-sectional surveys conducted in Slovakia (N = 1,017 in 2019; N = 834 in 2025). Self-harm was assessed using selected physical forms from the Self-Harm Inventory, and depressive symptoms were measured using the Child Depression Inventory. The results indicated a significant positive association between depressive symptoms and self-harm in both cohorts; however, the strength of this relationship decreased in 2025. While depressive symptoms significantly increased over time, the variability of self-harm behaviors declined. Age and sex emerged as significant moderating factors, with age moderating the relationship in 2019 and sex in 2025. Girls showed a higher likelihood of self-harm, whereas the association between depression and self-harm was weaker among them. These findings suggest a potential shift from intrapsychic models of self-harm toward more complex frameworks that incorporate social and contextual influences. The results highlight the importance of considering broader environmental factors in understanding self-harm in contemporary adolescent populations.