Send to

Choose Destination
Clin Psychol Rev. 2015 Dec;42:156-67. doi: 10.1016/j.cpr.2015.09.002. Epub 2015 Sep 12.

Meta-analysis of risk factors for nonsuicidal self-injury.

Author information

Department of Psychology, Harvard University, United States. Electronic address:
Department of Psychology, Harvard University, United States.
Department of Psychology, Harvard University, United States; Military Suicide Research Consortium, United States.
Center for Anxiety and Related Disorders, Boston University, United States.


Nonsuicidal self-injury (NSSI) is a prevalent and dangerous phenomenon associated with many negative outcomes, including future suicidal behaviors. Research on these behaviors has primarily focused on correlates; however, an emerging body of research has focused on NSSI risk factors. To provide a summary of current knowledge about NSSI risk factors, we conducted a meta-analysis of published, prospective studies longitudinally predicting NSSI. This included 20 published reports across 5078 unique participants. Results from a random-effects model demonstrated significant, albeit weak, overall prediction of NSSI (OR=1.59; 95% CI: 1.50 to 1.69). Among specific NSSI risk factors, prior history of NSSI, cluster b, and hopelessness yielded the strongest effects (ORs>3.0); all remaining risk factor categories produced ORs near or below 2.0. NSSI measurement, sample type, sample age, and prediction case measurement type (i.e., binary versus continuous) moderated these effects. Additionally, results highlighted several limitations of the existing literature, including idiosyncratic NSSI measurement and few studies among samples with NSSI histories. These findings indicate that few strong NSSI risk factors have been identified, and suggest a need for examination of novel risk factors, standardized NSSI measurement, and study samples with a history of NSSI.


Longitudinal; Meta-analysis; NSSI; Prediction; Risk factor; Self-injury

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center