What are the correlates of non-suicidal self-injury in children and adolescents? An umbrella systematic review of global evidence.
Yi Zhong, Zi-Wei Zhang, Jia-Hao Ding et al.
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In 30 seconds
This umbrella systematic review synthesised meta-analyses of observational studies examining correlates of non-suicidal self-injury (NSSI) in children and adolescents. It included 16 meta-analyses covering 410 primary studies, 43 risk factors and 2,659,156 young people across 38 countries. Eighteen risk factors had highly suggestive evidence of association with NSSI. Suggestive evidence linked adverse childhood experiences with NSSI (2.31, 1.77-3.01) and being left-behind children with NSSI (1.37, 1.11-1.69). The review found correlates across individual, family, school/peer and multifactorial domains.
Key findings
- The review covered 16 meta-analyses, 410 primary studies and 2,659,156 children and adolescents across 38 countries.
- Eighteen of 43 risk factors had highly suggestive evidence of association with NSSI.
- Adverse childhood experiences were associated with NSSI with suggestive evidence (2.31, 1.77-3.01).
- Being left-behind children was associated with NSSI with suggestive evidence (1.37, 1.11-1.69).
Why it matters
The findings frame NSSI as associated with factors spanning several levels rather than a single domain. For clinicians and prevention planners, this supports considering a broad range of individual, family and school or peer circumstances when assessing risk and designing prevention approaches, while recognising that the strength of evidence varies across reported correlates.
What to keep in mind
The review synthesised meta-analyses of observational studies, so reported associations do not establish causation; evidence credibility varied across risk factors.