Meta-analysis of risk factors for nonsuicidal self-injury
Open accessAbstract
Nonsuicidal self-injury (NSSI) is a prevalent and dangerous phenomenon associated with many negative outcomes, including future suicidal behaviors. Research on these behaviors has primarily focused on correlates; however, an emerging body of research has focused on NSSI risk factors. To provide a summary of current knowledge about NSSI risk factors, we conducted a meta-analysis of published, prospective studies longitudinally predicting NSSI. This included 20 published reports across 5078 unique participants. Results from a random-effects model demonstrated significant, albeit weak, overall prediction of NSSI (OR=1.59; 95% CI: 1.50 to 1.69). Among specific NSSI risk factors, prior history of NSSI, cluster b, and hopelessness yielded the strongest effects (ORs>3.0); all remaining risk factor categories produced ORs near or below 2.0. NSSI measurement, sample type, sample age, and prediction case measurement type (i.e., binary versus continuous) moderated these effects. Additionally, results highlighted several limitations of the existing literature, including idiosyncratic NSSI measurement and few studies among samples with NSSI histories. These findings indicate that few strong NSSI risk factors have been identified, and suggest a need for examination of novel risk factors, standardized NSSI measurement, and study samples with a history of NSSI.
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Meta-analyses of longitudinal studies have highlighted suicidal ideation, previous self-harm, and psychiatric disorders as replicated risk factors.
“Meta-analyses of longitudinal studies have highlighted suicidal ideation, previous self-harm, and psychiatric disorders as replicated risk factors,68, 69, 70, 71, 72”
From Risk factors for self-harm in prison: a systematic review and meta-analysis (2020) · cites this paper as [68]
Previous self-harm is among the strongest predictors of future self-harm and suicide.
“Given that previous self-harm is among the strongest predictors of future self-harm68, 69, 70 and suicide,9, 10”
From Risk factors for self-harm in prison: a systematic review and meta-analysis (2020) · cites this paper as [68]
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“Nevertheless, prior research clearly has revealed NSSI as both a correlate and risk factor for suicidal ideation and behavior; yet the predictors and developmental course of NSSI differ from that of suicidal ideation and behaviors (see reviews by Fox et al. 2015 and Liu et al. 2017).”
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- Authors
- Fox, K. R., Franklin, J. C., Ribeiro, J. D., Kleiman, E. M., Bentley, K. H., & Nock, M. K.
- Affiliations
- Harvard University (US)
- Boston University (US)
- Corresponding author
- Fox, Kathryn R.
- ORCID
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 42
- Pages
- 156-167
- ISSN
- 0272-7358 (ISSN-L)
- PMC
- PMC4772426
- OpenAlex
- W1738630770
- Cited by
- 548
- References
- 72
- Citations by year
- 2026: 51 · 2025: 61 · 2024: 64 · 2023: 97 · 2022: 49 · 2021: 77 · 2020: 43 · 2019: 32 · 2018: 36 · 2017: 23 · 2016: 13 · 2014: 1 · 2012: 1
- FWCI
- 3.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institute of Mental Health (T32MH018921)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- non-suicidal self-injury, risk factors, cluster B personality disorders, hopelessness, suicidal behavior, longitudinal prediction
- MeSH terms
- Adolescent, Adult, Child, Humans, Risk Factors, Self-Injurious Behavior, Young Adult
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