ArticlePloS one2026
Non-suicidal self-injury and subsequent suicide attempts and death: A protocol for a systematic review of temporally ordered evidence.
Article in PloS one, 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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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
backgroundNon-suicidal self-injury (NSSI) is a prevalent and clinically significant behaviour, particularly among adolescents and young adults, and is strongly associated with suicidal behaviour. However, existing reviews have often combined heterogeneous outcomes, including suicidal ideation, plans, attempts, and death, limiting the identification of clinically meaningful pathways.
objectiveThis protocol describes a systematic review that aims to synthesise evidence on the temporally ordered relationship between NSSI and subsequent suicide attempts or death, and to examine whether characteristics of NSSI are associated with increased risk or severity of later suicidal behaviour.
methodsThis protocol is reported in accordance with PRISMA-P 2015 and registered with the Open Science Framework (OSF; https://doi.org/10.17605/OSF.IO/EA4M6). A comprehensive search will be conducted in MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science. Eligible studies will include prospective and retrospective observational studies demonstrating temporal ordering between NSSI and subsequent suicide attempts or death. Studies focusing solely on suicidal ideation will be excluded. Data extraction and risk-of-bias assessment will be conducted independently by two reviewers using Joanna Briggs Institute tools. Due to anticipated heterogeneity, findings will be synthesised using a structured narrative approach.
conclusionThis review will provide a focused synthesis of evidence on the relationship between NSSI and subsequent suicidal outcomes, addressing gaps related to temporality, outcome specificity, and severity. The findings are expected to inform clinical formulation, safety planning, and future research on suicide prevention by improving understanding of factors associated with subsequent suicidal behaviour.
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