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Published: 2026-07-06
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DOI: https://doi.org/10.52852/tcncyh.v203i6.5578
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Vol. 203 No. 6 (2026)
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Các bài báo
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An, N. H. M., Sang, H. T. M., Sơn, L. T., Tuấn Anh, L. T. ., Khanh, N. T. K., & Tuy, N. V. (2026). Social media addiction and non-suicidal self-injury among high school students: Sequential mediation analysis. Journal of Medical Research, 203(6), 899-906. https://doi.org/10.52852/tcncyh.v203i6.5578

Social media addiction and non-suicidal self-injury among high school students: Sequential mediation analysis

Nguyen Huu Minh An, Ho Thi Minh Sang, Le Trieu Son, Le Tran Tuan Anh, Nguyen Thi Kieu Khanh, Nguyen Van Tuy

Main Article Content

Abstract

A cross-sectional study was conducted among 747 students at Hai Ba Trung High School, Hue City (March–April 2026) to examine the mediating role of sleep disorders and self-esteem in the relationship between social media addiction and non-suicidal self-injury (NSSI). The tools used included BSMAS, PSQI, RSES, and FASM. Sequence mediating analysis was performed using PROCESS macros and bootstraps. Results showed NSSI prevalence of 38.3% (95% CI: 34.8 – 41.9%); 57.4% had poor sleep quality (PSQI > 5). BSMAS correlated positively with PSQI (r = 0.312; p < 0.001) and negatively with RSES (r = −0.321; p < 0.001). The direct effect between social media addiction and NSSI was not statistically significant, while the indirect effect through the sleep disorder → low self-esteem chain was significant. The results support a fully mediated model, indicating that social media addiction is associated with NSSI through impaired sleep and self-esteem. Intervention is needed to prevent NSSI.

Article Details

Keywords

social media addiction, non-suicidal self-injury, sleep disorder, self-esteem, high school students, sequential mediation analysis

References

1. Nock MK. Self-injury. Annu Rev Clin Psychol. 2010;6:339-63. doi:10.1146/annurev.clinpsy.121208.131258
2. Armoon B, Mohammadi R, Griffiths MD. The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis. Community Ment Health J. Jul 2024;60(5):919-944. doi:10.1007/s10597-024-01245-y
3. Nguyen DT, Dedding C, Pham TT, Wright P, Bunders J. Depression, anxiety, and suicidal ideation among Vietnamese secondary school students and proposed solutions: a cross-sectional study. BMC Public Health. Dec 17 2013;13:1195. doi:10.1186/1471-2458-13-1195
4. Tran QA, Dunne MP, Vo TV, Luu NH. Adverse Childhood Experiences and the Health of University Students in Eight Provinces of Vietnam. Asia Pac J Public Health. Nov 2015;27(8 Suppl):26s-32s. doi:10.1177/1010539515589812
5. Brunborg GS, Mentzoni RA, Frøyland LR. Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems? J Behav Addict. Mar 2014;3(1):27-32. doi:10.1556/jba.3.2014.002
6. Vannucci A, Flannery KM, Ohannessian CM. Social media use and anxiety in emerging adults. J Affect Disord. Jan 1 2017;207:163-166. doi:10.1016/j.jad.2016.08.040
7. Boer M, Stevens GWJM, Finkenauer C, de Looze ME, van den Eijnden RJJM. Social media use intensity, social media use problems, and mental health among adolescents: Investigating directionality and mediating processes. Computers in Human Behavior. 2021/03/01/ 2021;116:106645. doi:https://doi.org/10.1016/j.chb.2020.106645
8. Levenson JC, Shensa A, Sidani JE, Colditz JB, Primack BA. The association between social media use and sleep disturbance among young adults. Prev Med. Apr 2016;85:36-41. doi:10.1016/j.ypmed.2016.01.001
9. Woods HC, Scott H. #Sleepyteens: Social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. J Adolesc. Aug 2016;51:41-9. doi:10.1016/j.adolescence.2016.05.008
10. Mann M, Hosman CM, Schaalma HP, de Vries NK. Self-esteem in a broad-spectrum approach for mental health promotion. Health Educ Res. Aug 2004;19(4):357-72. doi:10.1093/her/cyg041
11. Orth U, Robins R. The Development of Self-Esteem. Current Directions in Psychological Science. 07/25 2014;23doi:10.1177/0963721414547414
12. Sellers CM, Díaz-Valdés A, Porter AC, et al. Nonsuicidal Self-injury, Suicide Planning, and Suicide Attempts Among High-risk Adolescents Prior to Psychiatric Hospitalization. Res Child Adolesc Psychopathol. Nov 2021;49(11):1503-1511. doi:10.1007/s10802-021-00830-z
13. AF H. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. Guilford Press; 2022.
14. Andreassen CS, Torsheim T, Brunborg GS, Pallesen S. Development of a Facebook Addiction Scale. Psychol Rep. Apr 2012;110(2):501-17. doi:10.2466/02.09.18.Pr0.110.2.501-517
15. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. May 1989;28(2):193-213. doi:10.1016/0165-1781(89)90047-4
16. Petersen W. Self Esteem and the Adolescent: Society and the Adolescent Self-Image. Morris Rosenberg. Princeton University Press, Princeton, N.J., 1965. xii + 326 pp. $6.50. Science. 1965;148(3671):804-804. doi:doi:10.1126/science.148.3671.804
17. Lloyd-Richardson EE, Perrine N, Dierker L, Kelley ML. Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychol Med. Aug 2007;37(8):1183-92. doi:10.1017/s003329170700027x
18. Swannell SV, Martin GE, Page A, Hasking P, St John NJ. Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide Life Threat Behav. Jun 2014;44(3):273-303. doi:10.1111/sltb.12070
19. Klonsky ED. The functions of deliberate self-injury: a review of the evidence. Clin Psychol Rev. Mar 2007;27(2):226-39. doi:10.1016/j.cpr.2006.08.002