Meta-analysis of risk factors for nonsuicidal self-injury

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 measure ment, and study samples with a history of NSSI.

Emotional Dysregulation and Nonsuicidal Self-Injury: A Meta-Analytic Review

“…In qualitative reviews of functions and models of NSSI, researchers found converging and the strongest evidence for the affect regulation function [11,33]. Other studies also reported a positive correlation between emotional dysregulation in general and NSSI [34]. But which aspects of emotional dysregulation are more strongly related to NSSI is still unknown.…”

Factors Contributing to Non-suicidal Self Injury in Korean Adolescents

“…Looking at an explanation of NSSI from the perspective of learning theory [8], the motivations for NSSI are explained in terms of the positive reinforcement as a behavior to attract others' attention and the negative reinforcement of using NSSI as a coping mechanism to alleviate emotional distress or discomfort. In other words, concerning the most common motivation for NSSI in adolescents, it is said that individuals engage in NSSI in order to fill the emotional holes that cannot be easily healed because of past psychological trauma or abuse experiences such as separation from parents, emotional abuse, and sexual abuse in their childhood and draw the attention of others [9,10], or NSSI functions as a means of feeling regulation which temporarily alleviates the negative emotions such as anxiety, depression, and stress when such negative emotions cannot be tolerated [3,6,9,11].…”

Letter to the Editor: Suicide as a complex classification problem: machine learning and related techniques can advance suicide prediction - a reply to Roaldset (2016)

“…This was also demonstrated by Bentley et al (2016) in a meta-analysis of anxiety disorders and symptoms as risk factors for suicidal thoughts and behaviors. Similarly, prediction was uniformly weak across individual risk factors for non-suicidal self-injury in a recent meta-analysis by Fox et al (2015). Accordingly, we propose that studies focused on suicidal thought and behavior prediction should prioritize the development of risk algorithms over risk factors.…”