Objective From the perspective of patients' self-identity, this article explores the correlations among coping strategies of adolescent patients with depression, parents' autonomous support, and self-identity, and also examines the mediating role of coping strategies.

Methods A total of 240 adolescent patients with depression from the First Hospital of Hebei Medical University were selected between August 2023 and July 2024. Basic information questionnaires, the Simplified Coping Style Questionnaire (SCSQ), the Parental Autonomy Support Scale (PASS), and the Self-Identity Scale (SIS) were used for the survey. Pearson correlation analysis was conducted to examine the relationships among coping styles of adolescent patients with depression, parental autonomy support, and self-identity. The SPSS macro program Process 4.1 was used to analyze the mediating role of coping styles between parental autonomy support and self-identity.

Results A total of 240 questionnaires were distributed in this study, and 236 valid questionnaires were collected, resulting in a recovery rate of 98.33%. The mean score for positive coping strategies among 236 adolescent patients with depression was (19.45 ± 2.68) points, while the mean score for negative coping strategies was (18.97 ± 5.04) points. The mean PASS score was (42.73 ± 9.98) points, and the mean SIS score was (48.64 ± 7.73) points. Pearson correlation analysis showed that positive coping strategies were positively correlated with parental autonomous support and self-identity (r = 0.267, 95% CI: 0.154-0.381; r = 0.207, 95% CI: 0.098-0.317). Negative coping strategies were negatively correlated with parental autonomous support and self-identity (r = －0.173, 95% CI: －0.290 to －0.054; r = －0.153, 95% CI: －0.265 to －0.039). Parental autonomous support was positively correlated with self-identity (r = 0.182, 95% CI: 0.052-0.313). The bootstrap method confirmed three mediating paths: Path 1 (parental autonomous support → positive coping → self-identity) had an effect value of 0.070 (95% CI: 0.021-0.162), accounting for 17.68% of the effect; Path 2 (parental autonomous support → negative coping → self-identity) had an effect value of 0.020 (95% CI: 0.005-0.042), accounting for 5.05% of the effect; Path 3 (parental autonomous support → positive coping → negative coping → self-identity) had an effect value of 0.017 (95% CI: 0.005-0.033), accounting for 4.29% of the effect. The 95% confidence intervals did not include 0, indicating that the indirect effects were significant.

Conclusion Parental autonomous support can directly affect the self-identity of adolescent patients with depression and can also indirectly influence it through coping strategies. Positive coping strategies mediate the beneficial effect of parental autonomous support on self-identity and play a protective role.