Associations between latent classes of left-behind experience and non-suicidal self-injury among rural adolescents: the sequential mediating roles of family functioning and shame

ObjectiveThis study aimed to identify latent classes of left-behind experience among rural Chinese adolescents and to examine the sequential mediating roles of family functioning and shame in the relationship between left-behind experience and NSSI.MethodsA cross-sectional survey was conducted among 1,735 rural middle school students with left-behind experience from two schools in Hunan Province, China, in 2024. Latent class analysis (LCA) was performed to identify subgroups of left-behind experience based on four indicators: age at parental separation, parental migration pattern, duration of parental migration, and frequency of communication with migrant parents. Correlation analysis, multiple linear regression, and a bootstrap-based sequential mediation model with 5,000 resamples were used to examine the relationships among latent class membership, family functioning, shame, and NSSI.ResultsLCA identified three distinct latent classes of left-behind experience: a low-risk group, a moderate-risk group, and a high-risk group. Correlation analyses showed that latent class membership was significantly associated with family functioning (ρ = −0.149, p < 0.05), shame (ρ = 0.139, p < 0.001), and NSSI (ρ = 0.142, p < 0.05). Family functioning was negatively associated with shame (r = −0.132, p < 0.001) and NSSI (r = −0.235, p < 0.001), whereas shame was positively associated with NSSI (r = 0.256, p < 0.001). Multiple regression analyses indicated that family functioning was negatively associated with shame (β = −0.126, p < 0.001) and NSSI (β = −0.204, p < 0.001), while shame was positively associated with NSSI (β = 0.229, p < 0.001). Sequential mediation analyses further indicated that, compared with the high-risk group, both the low-risk group (B = −0.107, 95% CI: −0.243 to −0.016) and the moderate-risk group (B = −0.143, 95% CI: −0.306 to −0.027) were associated with lower NSSI levels through the sequential pathway involving family functioning and shame.ConclusionLeft-behind experience among rural adolescents is heterogeneous, and different patterns are associated with varying levels of NSSI risk. Significant indirect associations involving family functioning and shame were observed between left-behind experience and NSSI, including a sequential indirect association through family functioning and shame. These findings suggest that family functioning and shame may represent relevant psychosocial factors to consider in future prevention efforts targeting NSSI among high-risk left-behind adolescents.