Cited by 548Suicide and Self-Harm StudiesPersonality Disorders and PsychopathologyHomicide, Infanticide, and Child Abuse

Meta-analysis of risk factors for nonsuicidal self-injury

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Fox, Kathryn R., Franklin, Joseph C., Ribeiro, Jessica D., Kleiman, Evan M., Bentley, Kate H., Nock, Matthew K.·2015·Clinical Psychology Review

Abstract

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”
  • 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”

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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.
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2015-12
Volume
42
Pages
156-167
ISSN
0272-7358 (ISSN-L)
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
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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