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Background <p>Non-suicidal self-injury (NSSI) persists as a major public health challenge worldwide. Identifying and strategically targeting risk factors for NSSI constitutes a practical approach to its prevention. We aim to synthesize existing knowledge concerning the range and magnitude of risk factors for NSSI among children and adolescents, and to critically assess the robustness of the available evidence.</p> Methods <p>In this umbrella review, six bibliographic databases were systematically searched for articles published from database inception to Dec 2024. For the assessment of evidence credibility, pre-specified criteria for classifying evidence were utilized, categorized as convincing (“class I”), highly suggestive (“class II”), suggestive (“class III”), weak (“class IV”), or no evidence (“class V”). The Amstar-2 framework was employed to evaluate the quality of the evidence which graded as “high,” “moderate,” “low,” or “critically low” quality.</p> Results <p>The study included meta-analyses of observational studies in the past 30 years on risk factors for NSSI in children and adolescents. We identified 16 meta-analyses comprising 410 primary studies on 43 risk factors from 38 countries, involving 2,659,156 children and adolescents. Twenty-three (e.g. LGBTIQ) risk factors were categorized as individual, followed by family level (<i>n</i> = 8, e.g. childhood maltreatment), school/peer level (<i>n</i> = 8, e.g. bully victims) and multifactorial level (<i>n</i> = 4, e.g. no religion). Eighteen (41.86%) risk factors provided highly suggestive (Class II) evidence of association with NSSI. Suggestive evidence (class III) indicated that NSSI was associated with adverse childhood experiences (2.31, 1.77–3.01) and being left-behind children (1.37, 1.11–1.69).</p> Conclusion <p>A multitude of risk factors spanning diverse domains were identified, highlighting the multifactorial nature of NSSI in adolescents and children. Comprehensive prevention strategies and measures should be conducted for children and adolescents to decrease the risk of NSSI and associated harms in multilevel approaches.</p> <p></p>

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What are the correlates of non-suicidal self-injury in children and adolescents? An umbrella systematic review of global evidence

  • 期刊论文

  • 发表日期：

    2026年4月14日

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  • Yi Zhong,
  • Zi-Wei Zhang,
  • Jia-Hao Ding,
  • Yan-Kun Sun,
  • Yong-Bo Zheng,
  • Yi-Fan Yu,
  • Zi-Chun Guan,
  • Si-Zhen Su,
  • Ting-Ting Wu,
  • Yi-Miao Gong,
  • Wei-Feng Mi,
  • Wei Yan,
  • Jie Sun,
  • Yu-Mei Wang,
  • Kai Yuan,
  • Le Shi,
  • Zhe Wang,
  • Afzal Javed,
  • Xiao-Xing Liu,
  • Yan-Ping Bao,
  • Danuta Wasserman,
  • Lin Lu

摘要

Background

Non-suicidal self-injury (NSSI) persists as a major public health challenge worldwide. Identifying and strategically targeting risk factors for NSSI constitutes a practical approach to its prevention. We aim to synthesize existing knowledge concerning the range and magnitude of risk factors for NSSI among children and adolescents, and to critically assess the robustness of the available evidence.

Methods

In this umbrella review, six bibliographic databases were systematically searched for articles published from database inception to Dec 2024. For the assessment of evidence credibility, pre-specified criteria for classifying evidence were utilized, categorized as convincing (“class I”), highly suggestive (“class II”), suggestive (“class III”), weak (“class IV”), or no evidence (“class V”). The Amstar-2 framework was employed to evaluate the quality of the evidence which graded as “high,” “moderate,” “low,” or “critically low” quality.

Results

The study included meta-analyses of observational studies in the past 30 years on risk factors for NSSI in children and adolescents. We identified 16 meta-analyses comprising 410 primary studies on 43 risk factors from 38 countries, involving 2,659,156 children and adolescents. Twenty-three (e.g. LGBTIQ) risk factors were categorized as individual, followed by family level (n = 8, e.g. childhood maltreatment), school/peer level (n = 8, e.g. bully victims) and multifactorial level (n = 4, e.g. no religion). Eighteen (41.86%) risk factors provided highly suggestive (Class II) evidence of association with NSSI. Suggestive evidence (class III) indicated that NSSI was associated with adverse childhood experiences (2.31, 1.77–3.01) and being left-behind children (1.37, 1.11–1.69).

Conclusion

A multitude of risk factors spanning diverse domains were identified, highlighting the multifactorial nature of NSSI in adolescents and children. Comprehensive prevention strategies and measures should be conducted for children and adolescents to decrease the risk of NSSI and associated harms in multilevel approaches.