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Multimodal Protocol for Assessing Metacognition and Self-Regulation in Adults with Learning Difficulties
Published on: September 27, 2020
Executive Function and Self-Injurious Thoughts and Behaviors: A Systematic Review and Meta-Analysis.
Shayna M Cheek1, Rachel F L Walsh2, Sarah E Barnes1
1Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina.
Biological Psychiatry
|May 28, 2026
Summary
Executive function deficits, including inhibitory control and working memory, are linked to self-harm and suicidal behaviors. These cognitive functions may help differentiate between suicidal thoughts and actions.
Area of Science:
- Neuroscience
- Psychology
- Psychiatry
Background:
- Executive functioning deficits are implicated in self-injurious thoughts and behaviors.
- Mechanisms differentiating suicidal thoughts from suicide attempts are not well understood.
- The role of executive function deficits in differentiating suicidal thoughts from behavior is undetermined.
Purpose of the Study:
- To systematically review and meta-analyze the association between core executive functions and self-injurious thoughts and behaviors.
- To investigate whether executive function deficits can differentiate between suicidal ideation, suicide attempts, and non-suicidal self-injury.
Main Methods:
- Searched PubMed and PsycINFO databases up to June 4th, 2025.
- Included 127 studies examining inhibitory control, cognitive flexibility, and working memory in relation to self-injurious thoughts and behaviors.
- Extracted associations and performed random-effects meta-analyses to derive Hedge's g.
Main Results:
- Deficits in inhibitory control, cognitive flexibility, and working memory were associated with suicidal ideation and suicide attempts.
- Medium pooled effects were observed for cognitive flexibility and working memory in non-suicidal self-injury.
- Task-switching and response inhibition were specific to suicidal ideation, while working memory and attentional control were specific to suicide attempts.
Conclusions:
- Executive function deficits are promising candidate mechanisms underlying self-injurious thoughts and behaviors.
- Further longitudinal research is needed to establish prognostic value.
- Findings may inform the selection of brain regions for neuromodulation treatments.
Keywords:
Executive functionMeta-analysisNeuropsychologySelf-injurious behaviorSuicideSystematic reviewMore Related Videos
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