From Screens to Self Injury: A Psychodynamic Interpretation of Empirical Data on Emotion Regulation, Smartphone Addiction, and Self-Injury in Adolescents

This study investigates how emotional dysregulation, problematic smartphone use, and peer relationship difficulties contribute to non-suicidal self-injury (NSSI) in adolescents, through a psychodynamic lens. Conducted within the LOOK@ME research-intervention project, a community sample of 300 Italian adolescents between years 2021 and 2023 (ages 11–17; M = 13.04, SD = 1.24; 50% female) who owned a smartphone, completed four validated instruments: the Difficulties in Emotion Regulation Scale – Short Form (DERS-SF), Smartphone Addiction Inventory (SPAI), Strengths and Difficulties Questionnaire (SDQ), and the Self-Injurious Thoughts and Behaviors Interview – Non-Suicidal version (SITBI-NS). Mean scores were: SPAI = 44.47 (SD = 14.16), DERS-SF = 2.40 (SD = 0.65), and self-injury index = 27.30 (SD = 12.40). Using SPSS PROCESS Model 4 (controlling for age and gender), SPAI was found to fully mediate the effect of emotional dysregulation on NSSI (indirect effect = 0.545, BootSE = 0.126, 95% CI [0.316, 0.809], standardized β = 0.21, p < .001; direct effect = 0.037, SE = 0.168, t = 0.22, p = .83; total effect = 0.582, SE = 0.161, t = 3.63, p < .001, R² = .054). Subscale analyses further revealed that, among the dimensions of emotional dysregulation, the limited access to effective regulatory strategies (DERS strategies subscale) exhibited the strongest association with NSSI. A secondary mediation analysis showed that peer relationship difficulties significantly predicted SPAI (b = 0.845, SE = 0.339, t = 2.49, p = .013), which partially mediated their effect on NSSI (indirect effect = 0.404, BootSE = 0.256, 95% CI [0.027, 0.994]). Psychodynamically, these findings highlight the role of limited regulatory strategies—conceptualized here as failures of ego-based defenses—in adolescent self-harm. When such internal strategies collapse, adolescents may resort to smartphone use as a provisional external defense. As this digital container inevitably proves insufficient, unresolved emotional distress ultimately finds expression through the body. By integrating psychometric analysis with dynamic theory, this study underscores the symbolic, affective, and relational dimensions of adolescent NSSI.