Cited by 351Suicide and Self-Harm StudiesPersonality Disorders and PsychopathologySubstance Abuse Treatment and Outcomes

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Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research.

Fox, Kathryn R., Huang, Xieyining, Guzmán, Eleonora M., Funsch, Kensie M., Cha, Christine B., Ribeiro, Jessica D., Franklin, Joseph C.·2020·Psychological Bulletin

DOI 10.1037/bul0000305

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Abstract

Self-injurious thoughts and behaviors (SITBs) are major public health concerns impacting a wide range of individuals and communities. Despite major efforts to develop and refine treatments to reduce SITBs, the efficacy of SITB interventions remains unclear. To provide a comprehensive summary of SITB treatment efficacy, we conducted a meta-analysis of published randomized controlled trials (RCTs) that have attempted to reduce SITBs. A total of 591 published articles from 1,125 unique RCTs with 3,458 effect sizes from the past 50 years were included. The random-effects meta-analysis yielded surprising findings: The overall intervention effects were small across all SITB outcomes; despite a near-exponential increase in the number of RCTs across five decades, intervention efficacy has not improved; all SITB interventions produced similarly small effects, and no intervention appeared significantly and consistently stronger than others; the overall small intervention effects were largely maintained at follow-up assessments; efficacy was similar across age groups, though effects were slightly weaker for child/adolescent populations and few studies focused on older adults; and major sample and study characteristics (e.g., control group type, treatment target, sample size, intervention length) did not consistently moderate treatment efficacy. This meta-analysis suggests that fundamental changes are needed to facilitate progress in SITB intervention efficacy. In particular, powerful interventions target the necessary causes of pathology, but little is known about SITB causes (vs. SITB correlates and risk factors). The field would accordingly benefit from the prioritization of research that aims to identify and target common necessary causes of SITBs. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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Authors: Fox, K. R., Huang, X., Guzmán, E. M., Funsch, K. M., Cha, C. B., Ribeiro, J. D., & Franklin, J. C.
Affiliations: University of Denver (US)
Florida State University (US)
Columbia University (US)
ORCID: Fox, Kathryn R.
Huang, Xieyining
Guzmán, Eleonora M.
Ribeiro, Jessica D.
Franklin, Joseph C.
Venue: Psychological Bulletin
Publisher: American Psychological Association (APA)
Published: 2020-12
Volume: 146
Issue: 12
Pages: 1117-1145
ISSN: 0033-2909 (ISSN-L)
1939-1455
DOI: 10.1037/bul0000305
OpenAlex: W3094828322
Cited by: 351
References: 37
Citations by year: 2026: 65 · 2025: 75 · 2024: 77 · 2023: 52 · 2022: 45 · 2021: 33 · 2020: 3
FWCI: 2.62
Type: journal article
Language: en
Open access: closed
Locations: Psychological Bulletin (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords: self-injurious thoughts and behaviors, suicide, treatment efficacy, intervention effects, follow-up maintenance, age differences in treatment response, risk factors
MeSH terms: Suicide Prevention, Antidepressive Agents, Crisis Intervention, Electroconvulsive Therapy, Hospitalization, Humans, Peer Group, Psychosurgery, Risk Factors, Social Support, Antipsychotic Agents, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Self-Injurious Behavior, Suicidal Ideation, Psychotherapy, Psychodynamic

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Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research.

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