SynthesisMolecular psychiatry2026
What are the correlates of non-suicidal self-injury in children and adolescents? An umbrella systematic review of global evidence.
Synthesis in Molecular psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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22 authors.
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Abstract
backgroundNon-suicidal self-injury (NSSI) persists as a major public health challenge worldwide. Identifying and strategically targeting risk factors for NSSI constitutes a practical approach to its prevention. We aim to synthesize existing knowledge concerning the range and magnitude of risk factors for NSSI among children and adolescents, and to critically assess the robustness of the available evidence.
methodsIn this umbrella review, six bibliographic databases were systematically searched for articles published from database inception to Dec 2024. For the assessment of evidence credibility, pre-specified criteria for classifying evidence were utilized, categorized as convincing ("class I"), highly suggestive ("class II"), suggestive ("class III"), weak ("class IV"), or no evidence ("class V"). The Amstar-2 framework was employed to evaluate the quality of the evidence which graded as "high," "moderate," "low," or "critically low" quality.
resultsThe study included meta-analyses of observational studies in the past 30 years on risk factors for NSSI in children and adolescents. We identified 16 meta-analyses comprising 410 primary studies on 43 risk factors from 38 countries, involving 2,659,156 children and adolescents. Twenty-three (e.g. LGBTIQ) risk factors were categorized as individual, followed by family level (n = 8, e.g. childhood maltreatment), school/peer level (n = 8, e.g. bully victims) and multifactorial level (n = 4, e.g. no religion). Eighteen (41.86%) risk factors provided highly suggestive (Class II) evidence of association with NSSI. Suggestive evidence (class III) indicated that NSSI was associated with adverse childhood experiences (2.31, 1.77-3.01) and being left-behind children (1.37, 1.11-1.69).
conclusionA multitude of risk factors spanning diverse domains were identified, highlighting the multifactorial nature of NSSI in adolescents and children. Comprehensive prevention strategies and measures should be conducted for children and adolescents to decrease the risk of NSSI and associated harms in multilevel approaches.
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