Impulsivity and self-harm in adolescence: a systematic review.

Area of Science:

• Psychology
• Adolescent Health
• Neuroscience

Background:

• Impulsivity is associated with self-harm, but methodological inconsistencies hinder understanding.
• Adolescents aged 11-25 years are a key demographic for studying this relationship.
• Previous research lacks integration across diverse conceptualizations and measurement methods.

Purpose of the Study:

• To systematically review and integrate findings on the association between impulsivity and self-harm in community-based adolescents.
• To examine how different concepts and methods of measuring impulsivity influence the observed relationship with self-harm.
• To identify specific facets of impulsivity linked to different aspects of self-harm behavior.

Main Methods:

• Systematic review of electronic databases (EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed, Cochrane Library) and reference lists.
• Inclusion criteria focused on community-based adolescents (11-25 years) and studies examining impulsivity and self-harm.
• Analysis of 28 studies meeting inclusion criteria, assessing variations in impulsivity conceptualization and self-harm specification.

Main Results:

• Twenty-four studies reported a significant association between impulsivity and self-harm.
• Mood-based impulsivity traits were consistently linked to lifetime non-suicidal self-injury.
• Cognitive impulsivity facets differentiated current from past self-harm and ideation from enaction.
• Behavioral impulsivity was particularly relevant under negative affect conditions.

Conclusions:

• Distinct facets of impulsivity confer unique risks across the self-harm lifespan in adolescents.
• Mood-based impulsivity may relate to the initiation of self-harm.
• Cognitive and behavioral impulsivity facets are associated with the maintenance and context of self-harm.
• Clinical interventions should consider targeting emotional reactivity, self-regulation, and decision-making skills.