Risk Factors for Non-Suicidal Self-Injury in Adolescents: Evidence from a Meta-Analysis of 18 Longitudinal Studies

Non-suicidal self-injury (NSSI) is a significant risk factor for subsequent suicidal ideation, suicidal behavior, and psychological disorders. This meta-analysis of published prospective studies has examined the longitudinal predictors of NSSI drawing on 18 published reports and 23,737 independent participants. The random effects model showed that the overall prediction of NSSI was significant (OR = 1.18, 95%CI[1.08-1.28]). These factors, which include depressive symptoms (OR = 1.21, 95%CI[1.10-1.33]), prior history of NSSI (OR = 2.34, 95%CI[1.66,3.29]), being female (OR = 1.59, 95%CI[1.01,2.53]), prior suicidal thought/behavior (OR = 2.35, 95%CI[1.32,4.16]), peer victimization (OR = 1.08, 95%CI[1.04,1.12]), exposure to peer NSSI/suicidal behavior (OR = 1.38, 95%CI[1.20,1.58]) and substance abuse (OR = 1.14, 95%CI[1.02,1.28]), were associated with an increased risk of NSSI among adolescents. This meta-analysis provides relatively strong evidence of the risk factors for NSSI in adolescents, and specific interventions can be targeted at high-risk populations to reduce the occurrence of NSSI. In the future, larger data and longer follow-up cohort studies should be conducted to examine the relationship between various influencing factors and NSSI in adolescents as well as possible related mechanisms.