Adverse childhood experiences and the risk of non-suicidal self-injury: a meta-analysis

Systematically evaluate the association between Adverse Childhood Experiences (ACEs) and the risk of Non-suicidal Self-Injury (NSSI), thereby providing evidence-based guidance for relevant prevention and early intervention strategies.

A systematic search was conducted across PubMed, Embase, Web of Science, and the Cochrane Library, from their inception to 30 November 2025, to identify observational studies reporting associations between ACEs and NSSI. Two researchers independently performed literature screening, data extraction, and quality assessment. Effect sizes were pooled using a random-effects model, with association strength expressed as odds ratios (OR) and their 95% confidence intervals (CI). Data analysis was conducted using Stata 15.

A total of 13 articles included. The meta-analysis results suggest that physical abuse [OR = 2.38, 95% CI (1.36, 4.16), I² = 99%], sexual abuse [OR = 1.88, 95% CI (1.24, 2.87), I² = 94.9%], ACEs≥2 [OR = 3.23, 95% CI (2.62, 3.99), I² = 89.9%], ACEs≥3 [OR = 6.13, 95% CI (4.07, 9.24), I² = 96.9%], emotional abuse [OR = 1.65, 95% CI (1.18, 2.32), I² = 97.9%] may increase the risk of NSSI.

In summary, the findings of this meta-analysis suggest that exposure to adverse childhood experiences may be related to an increased likelihood of non-suicidal self-injury. Different forms of childhood adversity, including physical abuse, sexual abuse, and emotional abuse, as well as cumulative exposure to multiple ACEs, were associated with higher risks of NSSI.

https://www.crd.york.ac.uk/prospero/, identifier CRD42026128495.