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A social ecological approach to social contagion of self-harm among young people

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Abstract

Self-harm has proven social contagion effects among young people. However, a comprehensive understanding of the complex dynamics that contribute to self-harm contagion in adolescents is lacking. In this Review, we synthesize evidence regarding the social contagion of self-harm in young people using a social ecological approach. At the individual level, psychological and neurobiological vulnerabilities increase young people’s susceptibility to social contagion. At the interpersonal level, social contagion of self-harm occurs through peer interactions and social media connections, as well as through family ties including parental, sibling and grandparental relationships. At the community level, social contagion is evident in high-risk clusters of young people in institutional settings (schools, universities, psychiatric hospitals and justice-involved youth institutes), on social media and in digital spaces, and in neighbourhoods, where socioeconomic disadvantage is a key structural constraint that amplifies self-harm contagion. At the societal level, media-regulation challenges, global pandemics and political context exacerbate the social contagion of self-harm by intensifying pre-existing risk factors across individual, interpersonal and community levels. We address these multilevel factors to bridge psychological and public health perspectives of social contagion dynamics and describe prevention and intervention efforts that might offer scalable, evidence-based solutions for mitigating self-harm among youth.

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Fig. 1: The social ecological model applied to self-harm contagion among young people.
Fig. 2: Individual vulnerabilities associated with self-harm contagion among young people.
Fig. 3: Relationships that shape self-harm contagion among young people.
Fig. 4: Self-harm contagion across interconnected levels and factors.

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Acknowledgements

The authors thank the Humanity and Social Science Youth foundation of the Ministry of Education (grant 22YJCZH018) for support.

Author information

Authors and Affiliations

  1. Vanke School of Public Health, Tsinghua University, Beijing, China

    Xue Wen & Runsen Chen

  2. School of Public Health, Brown University, Providence, RI, USA

    Shufang Sun

  3. Faculty of Psychology, Beijing Normal University, Beijing, China

    Danhua Lin

  4. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China

    Weihua Yue

  5. PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China

    Weihua Yue

Authors
  1. Xue Wen
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  2. Shufang Sun
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  3. Danhua Lin
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  4. Weihua Yue
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  5. Runsen Chen
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Contributions

X.W., W.Y. and R.C. conceived the paper. X.W. conducted the literature review, drafted the initial full manuscript, and created all tables and figures. S.S., D.L., W.Y. and R.C. provided comprehensive revisions to the manuscript, critically refining its structure and theoretical arguments. All authors reviewed the manuscript before submission.

Corresponding authors

Correspondence to Weihua Yue or Runsen Chen.

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Nature Reviews Psychology thanks Delfina Bilello, Massimiliano Orri and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Wen, X., Sun, S., Lin, D. et al. A social ecological approach to social contagion of self-harm among young people. Nat Rev Psychol (2025). https://doi.org/10.1038/s44159-025-00495-1

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