Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis
Open accessAbstract
Background: Adolescents with immature mind and unstable emotional control are high-risk groups of non-suicidal self-injury (NSSI) behavior. We meta-analyzed the global prevalence of NSSI and prevalence of NSSI characteristics in a non-clinical sample of adolescents between 2010 and 2021. Methods: A systematic search for relevant articles published from January 1, 2010 to June 30, 2021 was performed within the scholarly database search engines of CBM, CNKI, VIP, Wanfang, PubMed, Web of Science, PsycINFO, and Embase. Eligibility criteria were as follows: provided cross-sectional data on the prevalence of NSSI; the subjects were non-clinical sample adolescents; and a clear definition of NSSI was reported. We used the following definiton of NSSI as our standard: the deliberate, self-inflicted destruction of body tissue, such as cutting, burning, and biting, without attempted suicide. The quality evaluation tool for cross-sectional studies recommended by the JBI was used. The global prevalence of NSSI was calculated based on the random-effects model by Comprehensive Meta-analysis version 3.0. Subgroup analyses were performed to compare the prevalence according to sex, living place, smoking or drinking history, and family structure. Results: Sixty-two studies involving 264,638 adolescents were included. The aggregate prevalence of NSSI among a non-clinical sample of adolescents was similar between over a lifetime (22.0%, 95% CI 17.9–26.6) and during a 12-month period (23.2%, 95% CI 20.2–26.5). Repetitive NSSI was more common than episodic NSSI (20.3% vs. 8.3%) but the frequency of mild injury (12.6%) was similar to that of moderate injury (11.6%). Multiple-method NSSI occurred slightly more often compared than one-method NSSI (16.0% vs. 11.1%). The top three types of NSSI in adolescents were banging/hitting (12.0%, 95% CI 8.9–15.9), pinching (10.0%, 95% CI 6.7–14.8), and pulling hair (9.8%, 95% CI 8.3–11.5), and the least common type was swallowing drugs/toxic substances/chemicals (1.0%, 95% CI 0.5–2.2). Subgroup analyses showed that being female, smoking, drinking, having siblings, and belonging to a single-parent family may be linked to higher prevalence of NSSI. Conclusion: This meta-analysis found a high prevalence of NSSI in non-clinical sample of adolescents, but there are some changes in severity, methods, and reasons. Based on the current evidence, adolescents in modern society are more inclined to implement NSSI behavior by a variety of ways, which usually are repetitive, and moderate and severe injuries are gradually increasing. It is also worth noting that adolescents with siblings or in single-parent families are relatively more likely to implement NSSI behavior due to maladjustment to the new family model. Future research needs to continue to elucidate the features and risk factors of NSSI so as to intervene in a targeted way. Limitation: The limitation of this study is that the heterogeneity among the included studies is not low, and it is mainly related to Chinese and English studies. The results of this study should be used with caution. Systematic review registration: [ www.crd.york.ac.uk/prospero/ ], identifier [CRD42022283217].
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Self-harm without suicide intent in adolescence is widespread, with the prevalence rate of repetitive self-harm being around 20%.
“Self-harm (without suicide intent) in adolescence is also a widespread issue, with the prevalence rate of repetitive self-harm being around 20% (Xiao et al., 2022).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Xiao et al., 2022
There is a higher prevalence of self-harm in adolescents with a smoking history (24.7%) versus non-smoking adolescents (10.1%).
“They found a higher prevalence of self-harm in adolescents with a smoking history (24.7%) versus non-smoking adolescents (10.1%), as well as a higher prevalence of self-harm in adolescents with a history of alcohol consumption (24.4%) versus non-drink adolescents (9.3%) (Table 3).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Xiao et al. (2022)
The risk of self-harm was more prevalent in female youth compared to male youth.
“The most reported risk factor for self-harm was gender; Gillies et al. (2018), Xiao et al. (2022), and Wang et al. (2022), all identified that the risk of self-harm was more prevalent in female youth compared to male youth.”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Xiao et al. (2022)
Xiao et al. (2022) found a 25.4% NSSI prevalence for female adolescents compared to a 22% prevalence for males.
“In a review of 43 studies with 107,285 male and 102,473 female participants, Xiao et al. (2022) found a 25.4% NSSI prevalence for female adolescents compared to a 22% prevalence for males.”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Xiao et al. (2022)
There is a higher prevalence of self-harm in adolescents with a history of alcohol consumption (24.4%) versus non-drink adolescents (9.3%).
“They found a higher prevalence of self-harm in adolescents with a smoking history (24.7%) versus non-smoking adolescents (10.1%), as well as a higher prevalence of self-harm in adolescents with a history of alcohol consumption (24.4%) versus non-drink adolescents (9.3%) (Table 3).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Xiao et al. (2022)
Self-harm was more prevalent in adolescents from families with multiple children (27%) than families with one child (25.8%).
“They reported that self-harm was more prevalent in adolescents from families with multiple children (27%) than families with one child (25.8%), and self-harm was higher in adolescents from single-parent families (30%) than those from two-parent families.”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Xiao et al. (2022)
Self-harm was higher in adolescents from single-parent families (30%) than those from two-parent families.
“They reported that self-harm was more prevalent in adolescents from families with multiple children (27%) than families with one child (25.8%), and self-harm was higher in adolescents from single-parent families (30%) than those from two-parent families.”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Xiao et al. (2022)
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Avon, V., Gullo, N. A., & Walker, D. C. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22010089 · Cited by 4 · see citing works
Riva, A., Panarella, C., Arienti, G., Guardo, S. D., Brasola, E., Nacinovich, R., & Cavanna, A. E. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70134 · Cited by 4 · see citing works
Xu, S., Bai, R., Xue, D., & Liu, X. (2025) · Psychology Research and Behavior Management · doi:10.2147/prbm.s530888 · Cited by 5 · see citing works
Кибитов, А. А., Потанин, С. С., Borodin, V., & Ma, M. (2025) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro2025125101128 · Cited by 4 · see citing works
Liang, Y., Gao, Y., Tian, M., Chen, X., & Liu, X. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02923-2 · Cited by 4 · see citing works
Risk and protective factors for nonsuicidal self-injury among adolescents: a latent profile analysis
He, Y., Kong, Y., Ji, T., Tao, R., Liu, G., & Yuan, F. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1713461 · Cited by 4 · see citing works
- Authors
- Xiao, Q., Song, X., Huang, L., Hou, D., & Huang, X.
- Affiliations
- Sichuan University (CN)
- Corresponding author
- Huang, Xuehua
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2022-08-10
- Volume
- 13
- Pages
- 912441-912441
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC9399519
- OpenAlex
- W4290989029
- Cited by
- 316
- References
- 80
- Citations by year
- 2026: 90 · 2025: 130 · 2024: 62 · 2023: 33 · 2022: 1
- FWCI
- 9.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Department of Science and Technology of Sichuan Province (2021YFS0151)
- Health Commission of Sichuan Province
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- non-suicidal self-injury, adolescents, prevalence, non-clinical sample, injury severity, sex differences, family structure, living place, emotion regulation, impulsivity
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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