Depressive Symptoms and Self-Harming Behavior in Adolescents: Examining the Moderating Roles of Age and Gender

Abstract

Self-harm and depressive symptoms are important mental health concerns during adolescence, yet the factors shaping their association remain insufficiently understood. This exploratory cross-sectional study examined the association between depressive symptoms and self-harming behavior and tested whether age and gender moderated this relationship. A total of 1116 Slovak adolescents aged 11–19 years completed the Self-Harm Inventory and Children’s Depression Inventory. Spearman’s correlation, Mann–Whitney U test, linear regression, and moderation analyses using PROCESS were conducted. Depressive symptoms were moderately positively associated with self-harming behavior (ρ = 0.526, p < 0.001). Adolescents reporting repeated self-harm had significantly higher depressive symptom levels than the reference group, with a moderate-to-large group difference (r = 0.45). Depressive symptoms explained 32.3% of the variance in self-harm scores. Gender significantly moderated this association in the primary analysis, with stronger associations among women than men; however, the interaction explained only an additional 0.7% of variance (ΔR2 = 0.007). Age did not significantly moderate the association. These findings indicate that depressive symptoms are an important correlate of adolescent self-harm, while the modestly stronger association observed among women suggests that gender may add nuance to this relationship, although this difference was not consistently observed across sensitivity analyses.